The Psychologist November 2019

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Making your way through the retirement maze www.thepsychologist.org.uk

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contact The British Psychological Society 48 Princess Road East Leicester LE1 7DR 0116 254 9568 info@bps.org.uk www.bps.org.uk the psychologist and research digest www.thepsychologist.org.uk www.bps.org.uk/digest www.jobsinpsychology.co.uk psychologist@bps.org.uk Twitter: @psychmag Download our iOS/Android apps advertising Reach 50,000+ psychologists at very reasonable rates. CPL, 1 Cambridge Technopark Newmarket Road Cambridge CB5 8PB contact Kai Theriault 01223 378051 kai.theriault@cpl.co.uk october 2019 issue 52,557 dispatched cover Karin Creemers www.karincreemers-illustrator.com environment Printed by Warners Midlands plc on 100 per cent recycled paper. Please re-use and recycle. Mailing bag is potato starch-based and fully compostable. issn 0952-8229 (print) 2398-1598 (online)

© Copyright for all published material is held by the British Psychological Society unless specifically stated otherwise. As the Society is a party to the Copyright Licensing Agency (CLA) agreement, articles in The Psychologist may be copied by libraries and other organisations under the terms of their own CLA licences (www.cla.co.uk). Permission must be obtained for any other use beyond fair dealing authorised by copyright legislation. For further information about copyright and obtaining permissions, e-mail permissions@bps.org.uk.

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Making your way through the retirement maze www.thepsychologist.org.uk

The Psychologist is the magazine of The British Psychological Society It provides a forum for communication, discussion and controversy among all members of the Society, and aims to fulfil the main object of the Royal Charter, ‘to promote the advancement and diffusion of a knowledge of psychology pure and applied’

The Psychologist needs you! We rely on your submissions throughout the publication, and in return we help you to get your message across to a large and diverse audience. For details of all the available options, plus our policies and what to do if you feel these have not been followed, see www.thepsychologist.org.uk/contribute The main message, though, is simply to engage with us. Contact the editor Dr Jon Sutton on jon.sutton@bps.org.uk, tweet us on @psychmag or call /write to us at the Society’s Leicester office.

Managing Editor Jon Sutton Deputy Editor Annie Brookman-Byrne Production Mike Thompson Journalist Ella Rhodes Editorial Assistant Debbie Gordon Research Digest Emily Reynolds, Emma Young, Matthew Warren

Associate Editors Articles Paul Curran, Harriet Gross, Michelle Hunter, Rebecca Knibb, Adrian Needs, Paul Redford, Sophie Scott, Mark Wetherell, Jill Wilkinson History of Psychology Alison Torn Interviews Gail Kinman Culture Kate Johnstone, Sally Marlow Books Emily Hutchinson Voices in Psychology Madeleine Pownall International panel Vaughan Bell, Uta Frith, Alex Haslam, Elizabeth Loftus, Asifa Majid Psychologist and Digest Editorial Advisory Committee Catherine Loveday (Chair), Emma Beard, Harriet Gross, Kimberley Hill, Rowena Hill, Deborah Husbands, Peter Olusoga, Richard Stephens, Miles Thomas

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psychologist november 2019

72 One on one …with Sidney Irvine

Dr Jon Sutton Managing Editor @psychmag

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66 Looking back Sarah Chaney on needle girls and motiveless malingerers

In Greek mythology, Zeus banished his son Tantalus to the very deepest part of the Underworld (to be fair, Tantalus appears to have largely brought this upon himself). There, he was to stand in a pool of water beneath a fruit tree. Whenever he reached for the fruit, the branches rose (‘tantalisingly’) away from his grasp. Whenever he bent down to get a drink, the water receded. For those of us in Generation X, the story of Tantalus is perhaps how we view discussion of pension age (p.12). But if we do get to retirement, will it be positive for our physical and mental health (p.24), and how might we make the most of it? ‘The Psychologist Guide to Retirement’, accompanying this issue and on our website, provides some evidencebased tips. Please do share with anyone you think might benefit from it. In the meantime, we must surely approach our working lives with stoicism the Greeks would have admired: resilience, positivity, work ethic. No, says David Frayne (p.50): ‘stop this nonsense’.

50 Books We meet David Frayne, author of The Refusal to Work; plus links to our latest online extracts 02 Letters Climate; prevention; Eysenck; digital health; and more 09 Obituary Peter Beaman 12 News Pension age; obesity; an interview with Janet Bultitude; and more

24 Digest Retirement

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30 ‘How does this fit into the real world of policing?’ Becky Milne on improving the interviewing of witnesses

34 The sibling spotlight Rachel Batchelor on the challenges facing the ‘forgotten’ brothers and sisters of seriously ill children

40 Finding a route to independence Emily Farran on navigation and the spatial domain in neurodevelopmental disorders 44 ‘It forced me to think in different ways about single- session therapy’ Windy Dryden meets Moshe Talmon

54 Culture Reasons to Stay Alive; Mistify; Another Me; and more

58 ‘You can always find something inside someone to work with’ We meet Yvette Bates, Senior Forensic Psychologist at HMP Dovegate

62 Jobs in psychology Featured job, latest vacancies

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Helping the older worker to thrive Getty Images

A think tank has recommended that working into older age can benefit health and wellbeing. Ella Rhodes asked psychologists what they made of the Centre for Social Justice recommendations.

Professor Gail Kinman

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The Centre for Social Justice (CSJ), co-founded and chaired by former Conservative work and pensions secretary Iain Duncan Smith, has suggested the state pension age should increase to 75 by 2035. The think tank, which was the first to propose the controversial Universal Credit scheme, released the report Ageing Confidently; supporting an ageing workforce as part of its Future of Work research programme (sponsored by Deutsche Bank and the Joseph Rowntree Foundation). A number of other recommendations include increasing access to flexible working, training, occupational health and mental health support, including so-called ‘mid-life MOTs’. The Centre for Ageing Better, an independent charitable foundation, recently released a report which expanded on what could be included in these mid-life MOTs. It suggested that employees should be encouraged to take stock of their wellbeing, both psychological and emotional, as well as their general health, finances, career and retirement plans. The CSJ suggests its own recommendations would ‘provide older people and employers with the support needed to unlock the potential of this demographic and enable older people to access the benefits of work’. But what are these benefits of work? And do we know enough about the psychological toll of working late into life? One 2016 study published in the Journal of Epidemiology & Community Health found being one year older at the age of retirement was associated with an 11 per cent lower risk of death, independent of many other

social and health-related factors. Unhealthy retirees also had a lower risk of death when they retired later. Another study in the Journal of Occupational Health Psychology, published in 2014, found those who worked in mentallydemanding jobs had better cognitive functioning prior to retirement and a slower decline in cognitive ability postretirement. [See p.24 for more on this research] Professor of Occupational Health Psychology Gail Kinman (University of Bedfordshire) said this report, while considering psychological evidence, would have benefitted from occupational and health psychology perspectives. ‘We need to highlight the health benefits of working longer, but it is crucial that people have a sense of autonomy over the type of work they do and the hours they work. Many older workers feel that being “forced” to work for longer has contravened the psychological contract they have with their employers when they were looking forward to a healthy and happy retirement.’ The report does recognise the benefits of flexible working on wellbeing – particularly important for those balancing work with physical health problems and care for family members. ‘It isn’t enough to provide access to flexible working though’, Kinman said. ‘There is strong evidence that the uptake of flexible options can be stigmatised as workers may be seen as less committed.’ Occupational Psychologist Gail Lincoln, featured in The Psychologist Guide to… Retirement which accompanies this issue, said the overall tone of the paper suggested that working longer is better, which is supported by some

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the psychologist november 2019 news evidence. It also suggested the retirement age is 100 years out of date due to an increase in life expectancy, yet this does not necessarily apply to the most deprived in the population. ‘The paper makes the point that healthy life expectancy is not keeping up with the increase in life expectancy. This potentially immediately weakens the initial argument for working longer.’ Lincoln said there were two other difficulties with the position the report took: choice and homogeneity. ‘The paper refers to “The Missing Million” who are not working but would like to. The point is well made… that many will be carers and have little choice, in addition to the inequalities of opportunity and ageism.’ Relatives, and particularly middle-aged women, often bear the brunt of caring for older people. The report stated that half of those not working just before retirement age have been prevented from doing so because of caring responsibilities. ‘This concurs with findings of my research’, Lincoln said. ‘More than half of the 60to 75-year-old women stated life-changing decisions had been put on hold due to the need to care for ageing partners or parents, also for grandchildren. This included decisions about moving for work, accepting paid-work and socialising.’ The CSJ report, Lincoln added, also falls into a familiar trap of treating older people as a homogeneous group. ‘Statistics are easy to manipulate by biased or incomplete presentation and interpretation. Overall trends relative to the EU indicate that whilst all countries have an increasing percentage of older people, the UK has the fastest rising fertility rates and relatively high levels of immigration of mainly younger people of all EU countries. These factors, in 2010, moved the UK from 2nd to 15th out of 27 EU countries for older people as a percentage of the population… we’re predicted to further drop to 23rd by 2035. This is a more positive comparative picture and is less alarmist than some of the figures used in the paper.’ Lincoln agrees, however, that an increasing percentage of older workers demands a greater level of support for people to remain in work if they choose to. Dr Nancy Doyle, an occupational psychologist and the founder and CEO of Genius Within, suggested that we need to start thinking about retirement more creatively, and that a single broad-brush policy will not work. ‘Anyone can plainly see that we cannot grow population exponentially, we already need three earths to provide resources for our current use of raw materials and carbon: the retirement Ponzi scheme has got to stop! Those who are most likely to suffer are manual workers and those without private provision, which will exacerbate social injustice. Is there a third way? Can we look at work itself differently in order to accommodate changing patterns across the lifespan? Doyle points out that our current worklife assumption is that individual careers ‘progress up the ladder, and then fall off the top. Even with portfolio careers, the expectation is of gaining and building on skills and value so that the point of retirement is at the peak of earnings. However, using the portfolio career model, we could create a “career pyramid” instead of a career ladder.’

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Tips from our Guide to Retirement

ps yc ho lo the

gi st mber 2019

No 6 Nove

1. Find new roles that enhance your sense of meaning or purpose. 2. Set aside 15 minutes each day to do something creative. 3. Get out of the house regularly to enjoy fresh air and meet people. 4. If you feel embarrassed to talk about sexual health with a professional take a prop (a print out of relevant information for example) with you to guide to… t help start a conversation. retiremen 5. When planning for retirement, incorporate leisure time. 6. Take advantage of new technologies and platforms to stay socially engaged. 7. Be kind to yourself during changing times. 8. Keep an open mindset and make flexible choices. 9. De-clutter sooner rather than later, in case you need to move unexpectedly. 10. Not everything declines with age… keep things in perspective! Sponsored

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The full guide is included with this issue. For the online version, along with previous guides, see https://thepsychologist.bps.org.uk/psychologist-guide

Doyle pointed to public sector workers who have gained skills, knowledge and experience over the decades but disappear when they retire. ‘This seems a waste of resources. I can quite see why firefighters, police, nurses and teachers cannot maintain the pace of full-time frontfacing employment beyond their fifties or sixties. However, for many who are lucky enough to retain reasonable health beyond middle age, their intellect skills do not evaporate! Could health and safety professions adopt exfirefighters and police? Could community nurses be exA&E? Could school inspectors and exam authors/markers be ex-teachers?’ She suggested that approaching public sector careers in this way could reduce the costs of retirement to the public and provide a ‘useful outlet for wise owls’. This career-pyramid approach, Doyle said, could address declines in mental wellbeing and health in retirement which may in part be due to the abrupt transition. ‘By smoothing the process we experience less of a jolt, and enjoy the feeling of being valued for experience and wisdom. Working into our seventies through choice and invitation could be motivational. And is it really unconventional? Consider the age of the top three democratic candidates for the US presidency right now! Workplaces are going to have to accommodate the aging workforce, whether we like it or not. The world of work is already shifting to accommodate disability, technology is revolutionising the potential for remote working, flexitime is no longer an odd request. In these changing norms the older worker could thrive.’

Gail Lincoln

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Understanding voices

Rachel Waddingham, Chair of the Hearing Voices Network (England)

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Around one in 10 people in the UK will hear voices others can’t, with one in 50 experiencing this on a regular basis. People’s experiences of these voices, and feelings towards them, can vary… a new website aims to support all of those who have struggled with the experience. The site, Understanding Voices, has been produced by Durham University’s Wellcome-funded Hearing the Voice project. This has worked closely with voice-hearers, their friends and families, the NHS, mental health charities and academics. It features accessible information and resources, including personal experiences, information on therapies and sources of support, and research articles, in an attempt to improve the lives of voice-hearers and raise awareness of hearing voices. Voice-hearers can include people who have been diagnosed with conditions such as schizophrenia, PTSD, OCD and psychosis, those who have never been diagnosed with a condition, and people who have experienced hearing voices over a single period of time. Understanding Voices, which aims to support people from any one of those groups who may be struggling, was launched at a special event in Newcastle upon Tyne in September. Dr Angela Woods, Co-Director of the Hearing the Voice project, said that voice-hearing experiences differed from person to person. ‘Some people feel very overwhelmed, while others find voices to be a valuable part of their life. While Understanding Voices will appeal to everyone interested in voice-hearing, its main aim is helping those who are struggling and looking for ways of understanding and dealing with it. Importantly, the website is based on the real experiences and knowledge of voice-hearers, mental health professionals and researchers, and includes a wide range of approaches to help people understand and manage voice-hearing.’

The website will also aim to share and celebrate the knowledge of the people who hear voices and who have been involved in its development. Rachel Waddingham, Chair of the Hearing Voices Network (England) and a member of the Understanding Voices Editorial Board, said that when she was first told her voices were hallucinations the foundations of her reality shook. ‘I didn’t know what to think, what to believe or how to move forwards. The voices intruded on every part of my life and, even with the best will in the world, the professionals in my life really didn’t seem to “get it”. I took medication to help quieten them, but even then they would return at times of stress and it would feel like we were back at the beginning. My whole family felt lost.’ Waddingham said that the knowledge that others out in the world experienced, and struggled with, the same issues was a big part of her route back. ‘I needed to know I wasn’t a freak. Information was another key part – the more I understood about my experiences, the more I was able to find a way of navigating them. I began to recognise the difficulties in my life that the voices expressed for me, albeit it very unhelpful ways. What took me years to find, by luck and the kindness of others, is contained in this single website. It’s a travel guide, opening up different pathways and ideas that can help people find solace, connection and inspiration. Connecting with the wider survivor, family member and mental health communities – I believe it will be an invaluable resource for voicehearers, their loved ones and supporters across the world.’ er Access the Understanding Voices website at understandingvoices.com

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Psycho persp logical ec obesity tives on policy, : Addressin g resear practice an ch pr iorities d

Septem ber

Policymakers should harness the power of psychology in tackling rates of obesity, a new British Psychological Society report has said. Rather than simply telling people to show greater willpower, we should aim to reduce the stigma associated with obesity, research the best ways of framing messages aimed at those struggling with their weight, move away from framing obesity as a choice in public health campaigns, and ensure weight management services don’t perpetuate obesity stigma. Written by a group of expert psychologists, Psychological perspectives on obesity: Addressing policy, practice and research priorities, explained what a psychologicallyinformed obesity policy would look like. One of the report’s authors, Dr Angel Chater (University of Bedfordshire, and Chair of the BPS Division of Health Psychology) said: ‘To address obesity, we need an understanding of all its causes – biological, psychological and social – and use approaches to behaviour change for prevention and weight management that are informed by psychology.’ The report called for the government to ensure every initiative aimed at promoting a healthy weight is informed by psychological evidence. It suggested that weight management services should be delivered by multidisciplinary teams

2019

Obesity

that include psychologists and that all health professionals working in obesity services should be trained in the psychological factors of obesity, so they can better understand what can contribute to the condition and to the success or failure of treatment. Chief Executive of the BPS, Sarb Bajwa, said the government had acknowledged the threat of obesity to the nation’s health in 1991 but the problem had continued to worsen. ‘We need a similar effort on obesity to the one we have seen on smoking. It has taken action at all levels for decades, from government policy to helping individual smokers, but we are now seeing significant reductions in the level of smoking and the health problems it causes. Psychologists have the science and clinical experience to help the health service do the same for obesity.’ To read the full report see bps.org.uk/obesity For a collection of obesity-related content from the archives of The Psychologist – including a new piece from Alex Bogaardt on ‘obesity stigma and the misdirection of responsibility’ – see https://thepsychologist.bps.org. uk/psychological-perspectives-obesity

the psychologist november 2019 news

Society and mental health An £8 million research centre is set to launch at King’s College, London bringing together academics with expertise in psychology, anthropology, sociology, epidemiology and geocomputation to investigate how our society affects mental health. Funded by the Economic and Social Research Council, the Centre for Society and Mental Health will focus on three main areas – the role of social and economic changes on young people, and on marginalised communities, as well as modern work and welfare policies and their impact on mental health. The research carried out at the centre will be developed alongside those who use mental health services, government departments, local authorities, schools, policy-makers and charities. Its multidisciplinary team is aiming to be involved in the creation of new policies to tackle the issues which may be driving mental health problems. Co-Director of the centre Professor Craig Morgan, from the Institute of Psychiatry, Psychology & Neuroscience, said in a statement that the centre would address one of the major challenges of our times – asking what are the effects of rapid social change on mental health, particularly among the most disadvantaged? ‘The factors that drive good and poor mental health lie in our communities, schools, and workplaces. Mental health problems develop across the life course and are more common among those who experience adversity. Our sustained and long-term research will help develop social policies and practices for creating environments that support mental health and give people the best chance of leading healthy, productive lives.’ The centre will be officially launched in January 2020 and will be based at the King’s College, London Strand Campus. er

Health psychologists awarded fellowships Three health psychologists have been awarded fellowships of the Royal College of Physicians Edinburgh. All members of the British Psychological Society Division of Health Psychology, their work has explored stress, drug use and disability. The Royal College awards fellowships annually for clinical achievement and peer-recognition among its members and recognises the work of individuals from related professions. Professor Valerie Morrison (Bangor University) was

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nominated for her research into drugs-crime associations within Scottish prisons and on changing illicit drug use as HIV emerged in Edinburgh in the late 1980s. Nominated for her research on behavioural change relating to health and disability advances as well as her influence in establishing health psychology in the UK and Europe was Professor Marie Johnston (University of Aberdeen). Dr Vivien Swanson (University of Stirling) was nominated for her research on home and work

stress among GPs and consultants in Scotland. Swanson said it was personally important to receive the fellowship award. ‘The College does some amazing work internationally, and it feels great to be part of this community of health care practice. It has also been brilliant to share the recognition from the College with other health psychology colleagues – and to feel that psychology can make a real contribution to improving people’s health.’ er

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Changing the online culture In a move to help universities in the battle against online harassment Universities UK and the University of Bedfordshire recently published guidelines on how best to deal with harassment and raise awareness of it. Changing the Culture: Tackling online harassment and promoting online welfare draws on evidence including higher education institutions’ existing practice, research from academia and anti-bullying charities, and the Bedfordshire Cyber Awareness Programme developed by the University’s National Centre for Cyberstalking Research (NCCR). According to anti-bullying charity Ditch the Label there has been an increase in the number of those aged 12 to 25 who have experienced online harassment from 17 per cent in 2017 to 30 per cent in 2019. While there’s an assumption that ‘digital natives’ know how best to spot and deal with harassment online this is not always the case, and UUK’s research also found that many who work in universities felt there was a great deal of complexity in responding to, and recognising, online harassment. The report makes more than 20 recommendations including

using the term ‘online harassment’ in policies and ensuring it is clear to staff and students that cyberbullying can constitute harassment or a hate crime, moving accountability for tackling online harassment to senior leadership teams and involving students in developing, executing and assessing initiatives to tackle online harassment while including students’ unions, academics and other staff. Dr Emma Short, Director of the NCCR and a Reader in Cyberpsychology said that universities should not assume that students always recognise abusive online behaviour or themselves feel equipped to respond to it. ‘There is a clear responsibility to safeguard students both from abuse, and the perpetration of abuse through a lack of awareness.’ The NCCR’s Bedfordshire Cyber Awareness Programme, a one-day training course, was used as a case study in the development of the guidelines. Short said it was designed to create a positive culture change, aiming to increase understanding of what constitutes unacceptable online behaviour and promote greater preparedness to seek help when encountering it. ‘Our initial findings did indicate a general tolerance of negative behaviours and a minimisation of possible risks, but changes in attitudes following the training were achieved. Most people indicated the course had increased their readiness and willingness to take action if they witnessed harmful online interactions.’ er To download a copy of the full report see: tinyurl.com/y335cgge

More news from the BPS

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John Oates, Chair of the BPS Media Ethics Advisory Group, recently led a response to an Ofcom consultation on protecting participants in TV and radio programmes. The broadcast regulator has proposed two new rules to help protect people taking part in programmes; that due care should be taken over the welfare, wellbeing and dignity of participants and that participants should not be caused ‘unjustified distress or anxiety’ in taking part in programmes or by the broadcasting of programmes. Ofcom cited a general growing concern over wellbeing and mental health in society, as well as a rise in complaints from members of the public concerned over the treatment of participants, as drivers for the implementation of its new rules. The

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BPS agreed that a duty of care should not stop once a person is over the age of 18 and suggested that guidance should be developed on including participants who have mental health problems. Six BPS members have been elected Fellows of the European Health Psychology Society. Dr Lucie ByrneDavis (University of Manchester), Dr Konstadina Griva (National University of Singapore), Professor Jo Hart (University of Manchester), Professor Dame Theresa Marteau (University of Cambridge), Professor Val Morrison (Bangor University) and Professor Daryl O’Connor (University of Leeds), were all elected at the society’s conference in Croatia, held in September.

At the Labour Party conference the BPS launched a briefing paper (tinyurl.com/y2q6sf7h) on the government’s new Mental Health Support Teams to be embedded in schools. It calls on the government to commit to reaching every child in England through the new scheme and to ensure psychological support in schools doesn’t become a postcode lottery. So far the government has committed to ‘at least a fifth to a quarter’ of areas being covered by these teams by 2022 to 2023, the paper suggests that unless this is extended further there is a risk that the level of support a young person can access will depend on where they live.

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the psychologist november 2019 news Getty Images

‘This will be a turning point…’ Between 2017 and 2018 one in four adults in England were prescribed drugs which could lead to dependence or debilitating withdrawal effects, a Public Health England review has revealed – with prescription rates rising for some classes of drug. Antidepressants were included in the review, for the first time in a government-level report, despite many years of denial that the drugs could cause long-term, severe withdrawal effects. The review, written with input from the British Psychological Society, also considered benzodiazepines, z-drugs (prescribed for insomnia), opioid pain medications, and gabapentinoids – all of which are associated with dependence and withdrawal. Between 2015 and 2016, 15.8 per cent of the adult population received prescriptions for antidepressants, rising to 16.6 per cent between 2017 and 2018. During the same two periods prescriptions for gabapentinoids rose from 2.9 per cent to 3.3 per cent. There were small decreases in prescriptions for the other three drug classes. The review also found that prescription rates for women were 1.5 times higher than for men, increasing with age. This pattern was most apparent in antidepressant prescriptions: between 2017 and 2018, 21.3 per cent of women and 11.6 per cent of men were prescribed the drugs. Prescription rates of antidepressants, opioids and gabapentinoids were also found to be higher in more deprived areas of England. Antidepressants have been associated with withdrawal effects, which vary between patients in terms of their length and severity. These effects can include flulike symptoms, insomnia, nausea, imbalance, sensory disturbances and hyperarousal. This has not always been officially acknowledged, but thanks to the work of the All Party Parliamentary Group for Prescribed Drug Dependence they were included in this review.

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Professor of Clinical Psychology John Read (University of East London) served on the PHE review expert reference group as a representative of the British Psychological Society, in part thanks to a systematic review on antidepressant medication he conducted with James Davies (University of Roehampton). That review found that more than half of people experience withdrawal effects when stopping antidepressant medication, that almost half of those described the effects as severe, and that withdrawal effects can last for weeks or months. ‘It really is a first for a government-level report to look into [antidepressant withdrawal] in that depth and come out with those strong recommendations acknowledging the extent of the problem’, Read told us. ‘It is hugely important. When we look back on all this in 20 years’ time this will be a turning point.’ ‘The final recommendation of the PHE report is for proper research… We absolutely need funding for not only the extent of the problem but more importantly how to help people come off. We just don’t know. We know for most people it’s better to do it very slowly, we know that people do report that the last little bit is the hardest… but we don’t have good research on the most effective form of support. We’re just at the beginning really. I think it’s a moral outrage that we’ve been prescribing millions and millions of these drugs for decades and we don’t know anything about how to help people come off.’ er For more on John Read’s involvement in the review, including the various controversies around including antidepressants, see https://thepsychologist.bps.org.uk/ when-we-look-back-20-years-time-will-be-turning-point To read the PHE review see: tinyurl.com/y5hqfld4

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Positive contact in a divided world Ella Rhodes reports from a joint British Academy/British Psychological Society lecture by Professor Rhiannon Turner

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In our diverse world, life brings us into contact with people people become more aware of their identities. People avoid contact with members of different of different identities, different races, different sexualities groups for a number of reasons, including anxiety. and different ages. When it’s done right, positive contact Turner explained that people fear that interactions will can have multiple benefits – changing how we view be awkward or that they will make a faux pas or behave others or perceive the world around us. While we may not inappropriately. This anxiety, or a lack of confidence, may consciously acknowledge it, crossing the divide to interact manifest in a rigid facial expression, increased distance with others can be difficult and anxiety-provoking. from the other person, avoidance of eye contact or Professor Rhiannon Turner (Queen’s University hesitation when talking. This may give the impression of Belfast) explained the importance of confidence when dislike or prejudice. engaging with those from different backgrounds. So what builds the confidence to engage in contact Confidence is a state of readiness regarding contact; with members of different groups? Turner and Dr Lindsey having the skills, beliefs and experiences for positive and Cameron (University of Kent) have argued that those who meaningful interactions with people who aren’t similar to feel confidence in contact have positive attitudes to other ourselves. groups, more positive expectations, good social skills and But why does contact with people from different lower anxiety. They also feel more groups matter? Gordon Allport’s similar to other groups, recognise contact hypothesis, described that having friends in other groups in his 1954 book ‘The Nature of is beneficial, and have a supportive Prejudice’, stated that contact friendship group and family. between different groups would Turner described interventions improve relations between based on extended, imagined, and them. The type of contact online contact, which may increase matters, though. For contact confidence in contact. Extended to be useful it should involve contact, a theory developed in cooperation to achieve common the mid-90s by Stephen Wright, goals. More recently it has been suggests that having friends suggested that contact should who themselves have friends be friendly and positive, and in different groups may reduce that friendship-based contact is prejudice towards those other one of the best ways to improve groups. Imagining contact with intergroup relations. the outgroup is a simple way of Contact with others may increasing confidence, leading to even affect our views of the more positive perceptions of other world. Turner pointed to an Professor Rhiannon Turner groups, increased confidence to association between seeing engage in contact and lowered anxiety around potential some groups as better than others and a willingness future interactions. to exploit the environment. If you have a deep belief in Some research suggests that online contact has status, your focus will more likely be on making money benefits over direct contact, allowing people to take for yourself than improving the environment to benefit more time to respond to others, and possibly making everyone. It has been suggested that having more contact self-disclosure more likely – important in forming with those outside your own group will lead to a greater relationships. feeling that all people are equal. Turner and Professor Roger Austin (University Turner wanted to investigate whether contact with of Ulster) have examined the use of virtual learning other groups could affect the perception of environmental environments to bring together pupils from Catholic and issues. Across four studies she and her colleagues found Protestant schools. Teachers have spoken positively about that those who had had positive contact with a range of these systems; they help children maintain and develop groups had more concern about environmental issues, friendships, prepare for face-to-face interactions, and acted in a more environmentally friendly way and were learn about their shared interests while also developing less likely to be climate change deniers. respect for difference. However, there’s a catch. People do tend to segregate In the future, Turner and Cameron hope to look themselves along group lines. In school cafeterias, longitudinally at the predictors and outcomes of Turner said, pupils divide themselves into ethnic groups. confidence in contact. Cross-group friendships tend to be less durable than same-group friendships, and the number of cross-group Read the full report online via thepsychologist.bps.org.uk friendships a person has tends to decline with age as

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the psychologist november 2019 news

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From Alcohol to Zebra fish by the Lakes Visit https://thepsychologist.bps.org.uk/shore-thing for a collection of coverage and interviews from the annual meeting of the British Psychological Society’s Psychobiology Section, including a report from this year’s event.

Screen time is a “Goldilocks topic” for our attention. Scientific topics can be “too hot”, “too cold”, or “just right” when it comes to whether they grab the attention of the masses… Screen time is serious enough that we click on articles that we think are new and important, but not so serious enough to receive the kind of scrutiny that might go along with a claim about a new cancer drug, or a new galaxy.’ An edited transcript from Professor Andrew Przybylski’s talk on ‘screen time debunked’ from Latitude Festival is now available. Visit https://thepsychologist.bps. org.uk/psychologist-presentslatitude-festival where you can read transcripts and reports from across our whole five years at the event.

Enter The Psychologist Poetry Competition 2019

thepsychologist.bps.org.uk/our-2019-poetry-competition Deadline 11 November

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‘I wanted to help people inspire others about psychology’ Dr Janet Bultitude is Director of Public Engagement for the University of Bath’s Psychology department. She recently won the Leadership Award at the university’s Public Engagement Awards. As told to Ella Rhodes. Different people think about public engagement in different ways, but some describe three types. One is outreach work, and this is what people usually first think of around public engagement – letting people know about your research, the topic of psychology and why it’s exciting. The second is to collaborate with non-academic

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audiences like government organisations, charities, individuals and patient groups, towards forming research ideas or collaborating in order to apply research. The third type is consulting non-academic audiences to find out, for example, how you can best shape your research to answer the sorts of questions that are really important. I’ve done a bit of public engagement throughout my academic career, right from when I was a PhD student. I’ve always had this interest but to actually take it on as an admin role in my department was a really exciting thing for me. We were already doing great public engagement, but I was excited by the opportunity to shape the way that people in our department can choose to do the best public engagement for what they want to achieve in inspiring others about psychology. The University of Bath has a fantastic Public Engagement Unit, and I see part of my role as liaising between them and the members of my department to help promote the most relevant public engagement activities and training, and to discuss how we can best develop our public engagement to make the most of the specific strengths of our department. There are some outreach events that are regular activities at the University of Bath and nationally that several people in our department take part in each year, like Pint of Science and Bath Taps into Science (the Bath University science festival). Another outreach event is Skype a Scientist; scientists are connected with schools anywhere in the world to Skype and tell them about their research or field in general. A similar event is I’m a Scientist, in which researchers answer questions from school students each day over social media. These are ways people can inspire different public audiences about their own research, or about psychology in general. There are some people in the department who have had placements at the government to help gain insight into how the government thinks about using scientific findings to shape policy. Sally Adams was selected for the Royal Society Pairing Scheme, which offers the opportunity for research scientists and parliamentarians and civil servants to learn about each other’s worlds. Abbie Jordan was awarded funding from the British Psychological Society for winning I’m a Scientist, and she is going to use this to host a cake decorating workshop with young people who are in chronic pain. You might think ‘what does that have to do with psychology?’, but doing something a bit interactive and creative can help you talk to people about their thoughts on their pain, how it has affected their lives, and what the big issues are for them. We’re very lucky to have a Psychology Widening Participation Officer, Suzanne Wilczoch. It’s a new role

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the psychologist november 2019 news and the University of Bath has appointed several people in similar roles in different departments. Some young people are at risk of having less opportunity to learn about what it’s like to go to university: for example people with older people I can connect them with others in the from lower socioeconomic backgrounds, those who go department who might have done public engagement to schools where there isn’t a very high rate of people along those lines. We also have a departmental going on to university, or where there’s not a high rate of newsletter where we have people writing pieces on the parents having been to university. Together with others public engagement they’ve done, so others can see in the department Suzanne is setting up more activities examples of good practice. that can inspire people from these sorts of backgrounds Because our department has grown considerably to think about applying to university. There are so many over the last several years, and there are no historic people from all walks of life who have the grades and records on what public engagement activities we took the right qualities to have really fulfilling experiences part in before I started in my role, I don’t have any hard studying and working in psychology but who just might data on whether any of the new steps I have helped to have never thought to apply. Diversity in our student body implement have caused the amount of public engagement and amongst people who work in psychology makes for more enriching environments, and better ensures that the to increase. Some of my colleagues tell me they think I’ve had an impact on the extent to which people engage needs and problems of all of society are being considered with non-academic audiences. I can see that, although and addressed. there are definitely many people who are doing very When I stepped into my role, I did a survey of the staff good public engagement without my input at all, there and postgraduate students, and one of the things I asked are some people who need a little was ‘what barriers are there to you nudge. I’d also emphasise that, at doing more public engagement?’. Not a senior level, public engagement “The final barrier, which surprisingly, the most common one is really valued in this department was time – or lack of it. Everyone in tended to be identified and also at the university. For this department who’s doing public by people earlier in their example, as the Director of Public engagement has other things they’re Engagement I sit on the department’s career, was they just doing… I can’t give people more time, executive committee because but what I can do is help them to weren’t quite sure what public engagement is considered think about how to use the little bit of to do in terms of public to be something that’s of strategic time they do have more strategically importance to the department. It’s engagement” to achieve what they want to achieve important to help people to realise out of public engagement. this is something that’s worth putting The next biggest barrier was their time into. a lack of funding. A lot of public In a way, this is the perfect admin engagement doesn’t cost much… contribution I can make to the department, because Our head of department, Greg Maio, figured out how to it’s something I’m genuinely passionate about. It’s very set aside a small pot of money people can apply for to rewarding because it involves a little bit of everything. Our support their public engagement events. We have limited research is generally publicly funded, so it’s only right funds, but it’s enough to cover travel, or pay for a lunch that we should involve the public, and it’s very fulfilling to for people attending their event. This is a small and easy facilitate that at the department level. From something step that any other psychology department could take to as small as a child coming out with a really interesting promote public engagement. comment when you do a demonstration with them, to a Another barrier was people not feeling skilledfocus group to identify new research directions, it can be up enough in the particular thing they wanted to do. I a really exciting way to get a different perspective on your identified the training people wanted and organised it. research. We had some very good training in how to talk to the Another aspect I find rewarding is that a lot of what radio and TV media from a team called Media Training I do is contributing to professional development. That International (they’re not paying me to say that!). That can be helping PhD students who might be doing public was a full-day training session that 33 people in the engagement for the first time, or it can be for staff department have now done. We’ve also had training from members who might have done public engagement an editor from The Conversation in how to write for them, before but now want to gain new skills or are considering which is really about how to write for a general audience. doing things that are perhaps a little bit scary like talking The final barrier, which tended to be identified by to the media directly. I can have my little role in making people earlier in their career, was they just weren’t that a bit easier for people. quite sure what to do in terms of public engagement. We addressed this by putting together a list of regular outreach events, often nice entry-level events that happen Dr Janet Bultitude is a Senior Lecturer in cognitive and every year. I also try to connect people who might be doing experimental psychology. similar things. If someone says they want to do something Find her on Twitter @janetbultitude

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Karin Creemers/www.karincreemers-illustrator.com

Retirement – a rosy picture? Emma Young digests the research

Find our Research Digest at www.bps. org.uk/ digest Editor: Dr Matthew Warren Writers: Emily Reynolds and Emma Young Full reports and much more on the Digest website

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If you ever daydream about retirement, what do you picture? Lie-ins, instead of being woken by an alarm? Walks on a beach, in place of the morning commute? More time for beloved hobbies? Or perhaps endless open, solitary days, with nothing much to do…? Retirement is what psychologists term a ‘major life transition’. As such, it’s regarded as a stressor that carries risks as well as potential rewards. Now that the number of retirees in many countries is soaring, so too is the number of studies into whether retirement is good for your mental and physical health – or not. This work certainly suggests that it can be, but there are a few warnings lurking in the results, too. In the inaugural issue of the journal Work, Aging and Retirement, published in 2015, Cornell University psychologist Peter Bamberger reviewed existing research on alcohol and other drug abuse among retirees and concluded that while the two are linked, retirement per se is not the cause. Rather, concerns about money and marital strains – both potential, but not inevitable, consequences of retirement – were associated with sleep difficulties, and with alcohol abuse among men. Bamberger’s analysis also revealed that people who’d felt pushed into retiring were most at risk of these problems. ‘The worst combination was among people who took early retirement from jobs they loved because they were terrified their companies were going under’, he says. ‘Among all groups studied, this one exhibited the highest incidence of substance abuse.’ A long-running study following Finnish people as they transition away from full-time work is providing all kinds

of insights into the impacts of retirement. Some of the results are positive; others, less so… In 2017, a team including researchers at the University of Turku, where the project is based, published details of a survey on alcohol consumption among this group. At the time of retirement, one in eight developed ‘risky’ levels of drinking (defined in this case as more than 24 units per week for men or 16 for women, or passing out due to extreme alcohol consumption). People in relatively low-status jobs and who lived in rural areas were most at risk. However, this was largely temporary; as the participants settled into retirement, there was a gradual decline in risky drinking. The study is also revealing some benefits, however. One analysis, led by Saana Myllyntausta and published in 2018, showed that when participants retired, they slept approximately 20 minutes longer per night and the quality of their sleep also improved. The retirees reported fewer early morning awakenings, and feeling more refreshed after a night’s sleep. However, a further study, led by Tuija Leskinen and also published in 2018, did find that they sat more, and more time spent sitting has been linked to poorer health. This group sat for an average of an hour and a quarter more each day on retiring. An extra half an hour per day spent watching TV helped to account for this. The researchers don’t comment on the potential role of cold and dark Finnish winters in driving this result…. But in sunny Australia, the story seems to be different. A major study that followed the lifestyle behaviours of more than 25,000 older Australians has found all

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When the team, led by Jeremy Hamm and Jutta Heckhausen at the University of California, Irvine, analysed the data on 1301 men and women around retirement age, they found that most people who were classed as being strongly engaged in various domains of life – with their romantic partners, children, their health, the welfare of others, their finances and work – maintained the same profile after retiring. ‘We found that work remained an important component of many people’s lives even after retirement’, they write. What’s more, the people who reported high levels of engagement in many (rather than few) spheres of life before and after retirement showed a better psychological adjustment to this shift. They had higher levels of perceived control in their lives (linked to a reduced risk of depression), and reported experiencing greater wellbeing. The main message from this work seems to be, yes, you may be leaving a long-term, and even a beloved, career on retiring; but that gives you more time to invest in family and physical exercise, for example, as well as other kinds of work. Maintaining all these investments of energy and time, or even increasing them, seems to be key to a psychologically successful transition. The team agrees with Melody Ding: ‘Retirement can be viewed as involving significant losses (eg disengaging from a valued career) but it also reflects a period in the life course when there may be opportunity for significant gains.’ I’ll leave the last word on this topic to Des, an 89-yearold Australian man who took part in the research led by Ding, and who has clearly adjusted well: ‘My answering machine message is “I am out enjoying my retirement”.’ Getty Images

kinds of positive shifts. Compared with people who were still working, the retirees spent 93 minutes more per week engaged in physical activity, sat down for 67 fewer minutes each day, and slept another 11 minutes per day. Also, half of the women who were smoking at the end of their working life stopped in retirement. There was no change in alcohol consumption. ‘Our research revealed that retirement was associated with positive lifestyle changes’, said lead researcher, Melody Ding, at the University of Sydney. In fact, retirement can be viewed as a great window of opportunity to get out of harmful health patterns and into beneficial ones, Ding argues. The biggest lifestyle improvements that her team observed in this group were among people who’d been working full-time, rather than part-time. Take work and the daily commute out of your life, and there’s a lot more time for exercise and other activities, she notes. Ding hopes that these results can help people to think positively about retirement. However, whether there are any actual improvements in physical health among older people who retire compared with those who stay in their jobs is less clear. Retirement itself doesn’t change the risk of major chronic illnesses such as respiratory disease, diabetes and heart disease, according to a study that assessed around 14,000 French men and women annually for 7 years prior to and 7 years after statutory retirement. This research, which was published in the British Medical Journal in 2010, did find a substantial drop in mental and physical fatigue and also symptoms of depression with retirement, though. Perhaps, as the Finnish and Australian work suggests, this group started to sleep longer. But the findings on tiredness might also reflect that older people, who are close to the age of retirement, find work more challenging, the researchers write. Stop work, and that challenge lifts. If the picture of the impacts of retirement on physical health seems a little unclear, well that’s exactly what a review of 22 longitudinal studies investigating links between retirement and health, published in 2013, concluded. The evidence on whether retirement affects perceived general health and physical health is contradictory, the researchers noted. For mental health, however, there was ‘strong evidence… for retirement having a beneficial effect’. On the whole, retirees reported improvements in symptoms of depression, distress and wellbeing. Still, as we already know, there are some factors associated with retirement – such as whether or not it’s forced or truly voluntary or whether it causes real financial stress – that might not make for such a rosy picture. And though, as a general rule, retirement may be beneficial for mental health, that’s not to say that stopping work of any kind is a good thing. In fact, now that ‘baby boomers’ are retiring, so is the nature of retirement, note the authors of a study of people in the US, published earlier this year. Though here people typically retire from full-time work in their early to mid60s, many go on to work part-time, perhaps in a different field, or start volunteering, or study, for example.

People who post lots of selfies to social media are seen as less likable or successful and more insecure. That’s according to a study in which participants rated people’s personalities based solely on their Instagram posts. The solution? Get someone else to take your photo, as people who posed for pictures were viewed much more positively. (Journal of Research in Personality).

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Illusory truth effect If you hear an unfounded statement often enough, you might just start believing that it’s true. This phenomenon, known as the ‘illusory truth effect’, is exploited by politicians and advertisers – and if you think you are immune to it, you’re probably wrong. In fact, earlier this year we reported on a study that found people are prone to the effect regardless of their particular cognitive profile. But that doesn’t mean there’s nothing we can do to protect ourselves against the illusion. A study in Cognition has found that using our own knowledge to fact-check a false claim can prevent us from believing it is true when it is later repeated. But we might need a bit of a nudge to get there. The illusory truth effect stems from the fact that we process repeated statements more fluently: we mistake that feeling of fluency for a signal that the statement is true. And the effect occurs even when we should know better — when we repeatedly hear a statement that we know is wrong, for instance, like ‘The fastest land animal is the leopard’. But Nadia Brashier at Harvard University and colleagues wondered whether asking people to focus on the accuracy of a statement could encourage them to use their knowledge instead, and avoid relying on feelings of fluency. In the initial study, the team first asked 103

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participants to read 60 widely-known facts, some of which were true (e.g. ‘The Italian city known for its canals is Venice’), and some of which were false (e.g. ‘The planet closest to the sun is Venus’). One group rated how interesting each statement was, while the other rated how true it was. Then in the second part of the study, both groups saw the same 60 statements along with 60 new ones – again a mixture of true and false – and rated their truthfulness. The researchers found that participants who had focused on how interesting the statements were in the first part of the study showed the illusory truth effect: they subsequently rated false statements which they had already seen as more true than false statements which were new. But the group that had initially focused on the accuracy of the statements didn’t show this effect, rating new and repeated false statements as equally true. This finding suggests that using our own knowledge to critically analyse a statement when we originally encounter it may inoculate us against the illusory truth effect. And this seems to have fairly long-lasting effects: in another experiment, the team found that participants who had initially focussed on the accuracy of the statements still showed no sign of succumbing to the illusory truth effect two days later. But considering the accuracy of a statement is only useful if we already have appropriate knowledge (e.g. that the closest planet to the sun is Mercury and not Venus). In further studies, the team found that rating the truthfulness of more obscure false statements which participants didn’t know much about, such as ‘The twenty-first U.S. president was Garfield’, didn’t later protect against the illusory truth effect. It would be interesting to know whether factchecking against external sources like the internet or reference books — which requires more effort than simply using our own knowledge — is effective at combating the illusion in these cases. Still, simply having the background knowledge needed to counter false claims is not always enough, say the authors — their results suggest people may need to be ‘nudged’ into actually using that knowledge. ‘Education only offers part of the solution to the misinformation crisis; we must also prompt people to carefully compare incoming claims to what they already know’, they write. Matthew Warren

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the psychologist november 2019 digest Getty Images

Psychologists have removed millions of calories from fast food customers’ diets by simply re-ordering the McDonald’s drink menu. Displaying Coke Zero in the first place rather than Coca-Cola ‘nudged’ people to choose the sugar-free option, the authors found. The intervention was so successful that McDonald’s continues to use the new item positioning to this day. (Psychology & Marketing).

Taking a placebo can reduce anxiety before a test, even when people know they are taking an inactive pill. Students approaching their end-of-term exams were given an open-label placebo to take for two weeks. By the end of the treatment period, their test anxiety had dropped – although they didn’t do any better in their exams than a control group. (Scientific Reports).

News reports tend to be dominated by gloomy stories – but there may be a bigger market for happy news than journalists realise. Researchers have found that, overall, people around the world show greater physiological levels of arousal to negative news clips. However, there was a huge amount of variability, with many individuals displaying greater arousal to positive clips instead - suggesting they have considerably different preferences. (PNAS).

Past adversity influences compassion Most of us would feel compassion towards a suffering child. But would we feel correspondingly more compassion towards a larger group of eight children? Well, probably not. People tend to show a ‘numeracy bias’ in compassion, where feelings of compassion don’t increase in response to greater numbers of people in distress. But a study in Emotion has found that people who have experienced adversity in their own lives are resistant to this bias. Participants read about the suffering of children in Darfur, Sudan and looked at pictures of either one war-stricken child, or eight. They were then asked about their feelings of compassion towards the child(ren). Those with little experience of adversity (e.g. bereavement or exposure to disasters) showed the numeracy bias. However, those with

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A picture taken 20 November 2007 of a Darfurian refugee girl in the Sudanese refugees camp (Photo credit OLIVIER LABANMATTEI/AFP/ Getty Images) higher levels of adverse experiences reported more compassion for multiple victims. This seemed to come from the fact they had a

stronger belief in their ability to actually make a difference to others who were suffering. Emma Young

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‘How does this fit into the real world of policing?’ For two decades Professor Becky Milne (University of Portsmouth) has worked to improve police interviewing of witnesses in the midst of crises. Ella Rhodes met her.

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fter taking a year out to work with the Gemini Trust during Ethiopia’s famine of the late 80s and early 90s, and a (happily) failed attempt at becoming an optician, Becky Milne ended up at Portsmouth Polytechnic studying psychology. Professor Ray Bull arrived at the university during Milne’s second year. Their working lives have been intertwined ever since, and it’s no surprise Milne calls him ‘Dad number two’. Bull has spent his career creating better methods for police to use during suspect and witness interviews and he was deeply involved, along with law enforcement professionals, in developing the ‘PEACE framework’. This approach encourages police to build rapport with interviewees before an interview begins, using active listening techniques. A conversational, rather than confrontational, questioning style is used, alongside a cognitive interview which helps obtain a more detailed account of events. After working on her third-year dissertation with Bull, Milne began a PhD with him in 1992 exploring police interviewing of vulnerable witnesses. ‘If I was going to study police interviewing for three years, I needed to find out what the police do. In that day and age it was very unusual to have outsiders go into the police, but I managed to work with Dorset police and observed what they did. I also went to America to work with Professor Ed Geiselman, who was one of the creators of the cognitive interview. I met the LAPD over there and they were using the cognitive interview and it was about to be introduced into Britain as part of the PEACE package which Ray was part of.’ During the early 90s Bull and Professor Stephen

Savage set up the Institute of Police and Criminological Studies (now the Institute of Criminal Justice Studies) at the University of Portsmouth, beginning the development of the first ever degree for police officers. The institute brought together psychologists and sociologists and it continues in that multi-disciplinary vein, melding the expertise of lawyers, ex-police officers and criminologists. ‘Throughout my career my teaching has been to practitioners so I’ve always had to work out, as a psychologist, how does all this theory fit?’, Milne says. ‘If you’ve got a room full of police officers who are paying to do a degree and you’re teaching communication skills or memory or perception, you need to apply it to make it relevant for them. From day one I’ve always had to ask how does this fit into the real world of policing, interviewing and investigation? I’ve learned so much sitting in a multi-disciplinary department. Achieving best evidence After she qualified Milne began supervision of PhD students – all of whom were initially police officers. She has so far supervised 18 and has 18 more currently under her supervision. She tells me she acts as ‘PhD mum’ in

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Davies (University of Leicester) were asked to redraft the university and many of her former PhD students the document in 1999 after the adoption of the Youth have sent her Mother’s Day cards in the past. Justice and Criminal Evidence Act to widen the net ‘My first PhD student, Colin Clarke, was a Met of who is allowed a video interview as their evidencepolice officer and was asked to examine the PEACE package, and whether it works, through a Home Office in-chief. This became known as the Achieving Best Evidence document and Milne was involved with grant. We did the first ever national review of police writing a later version of that document. interviewing post-PEACE. The result of that was the Clarke and Milne report, published in 2001, which was adopted by the Association of Chief Police Officers and ‘I had my lottery card that day’ put a lot of the things we said into policy and practice. Just over six years ago Milne survived a brain One of the things we recommended is teaching police haemorrhage, losing her vision and speech entirely. officers to interview across their careers. You can’t She gradually regained her vision do it in one lump… it needs to and later learned to speak again be drip-fed. We came up with with help from her specialist a tiered approach for interview “Good interviewers should nurses and neuropsychologist, training which was adopted tailor every interview to the with whom she built ‘wonderful nationally and has gone to lots of relationships’. different countries.’ individual in front of them” ‘In the early days I knew what For 16 years Milne has sat the words were and the semantics on the National Police Chiefs’ I could visualise them but I just Council board (formerly the couldn’t say them. It was quite interesting, I could Association of Chief Police Officers) as an academic describe them, I could say it’s about this long, starts lead on police interviewing in Britain, acting as a with an S. The words I struggled with were all very conduit between the worlds of policing and academia. Having written the Memorandum of Good Practice, the long words with an R in them – my neuropsychologist and I did a pattern analysis! first ever guidance on interviewing children for legal ‘When my neuropsychologist saw I was one of her purposes, Bull and his colleague Professor Graham

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the psychologist november 2019 policing

clients, she thought “oh my god”… she had one of my books on her shelf, she was still in training. But I thought it was brilliant. I told her I’d rather have one of my PhD students treating me, because you’re keen and up-to-date. Once she realised she could have fun, she asked if she could try loads of things out on my brain… I said of course you can! We had great fun bizarrely!’ Milne says that when she talks about trauma with police, ‘it’s quite interesting having gone through a brain injury it’s good to have felt what that’s like. I’m very lucky I had my lottery card that day, I tell you.’

FIT for practice Milne tells me a key challenge for researchers, even those who work in research with practitioners, is the transference of findings into practice. As a way to help criminal justice organisations use the best evidence in their practice, Milne and a former PhD student and retired Sussex Police Detective Superintendent Andy Griffiths, developed the Framework of Investigative Transformation (FIT). The model comprises eight evidence-based factors which need to be in place to ensure the decades of knowledge around interviewing and investigations are used in real-world criminal Gold standard justice organisations. Despite her injury, Milne has gained her professorship These FIT factors include a desire to change on since that time. And in the wake of the London Bridge the organisation’s part. ‘One country I spoke to six or terrorist attack in June 2017, she was called by an seven years ago told me “we don’t have miscarriages of Interview Advisor – a police officer who is trained justice here”, or “we’ve got no problem”. Seven years to the highest level in interviewing and is in charge later they’re coming over to the idea… it took them of interviewing strategy – for advice on how best to that long to want to change. The “want” in a want interview witnesses. to change is in inverted commas because normally ‘They had mass witnesses and trauma issues “wanting” to change comes after a miscarriage of including some with emergency services personnel. justice – we’re often forced to change.’ Between us we created a strategy. The first step is The other factors include leadership, legislation to triage. The gold standard of interviewing would and training regimes. Investigators should also take be a full visually-recorded interview with a highlyan open-minded and investigative approach when trained interviewer. We had to triage and categorise looking at cases, and should be provided with the right the witnesses, from people who had interaction with knowledge and technology. ‘I think terrorists to people who didn’t see we need to adopt new technology anything. Then we had to work more. We’re all bad at that because out who was best to interview each “One country I spoke to we hate change, but the criminal one.’ six or seven years ago justice system is particularly poor In such work, a ‘witness care at it. There’s something called the strategy’ operates alongside an told me ‘we don’t have handwritten police statement, and interview strategy. ‘Obviously miscarriages of justice I think it’s a blight on justice. If I you’ve got to take complete here’, or ‘we’ve got no could change that with the use of consideration of their health and more technology, that would be one wellbeing first… my job is to help problem’. Seven years I’d really like to change. What them do that and help them look later they’re coming over area we’re asking police officers to do at the triaging. Good interviewers to the idea…” at a crime scene is basically to ask should tailor every interview to the questions, listen to the answers, individual in front of them. I also and write them down. But human attended the structured debrief memory is very fragile. This is after the incident.’ not a very accurate process and so the officers end Given the number of terrorist attacks that have up, understandably, asking very closed questions and happened in recent years Milne began looking at the sometimes leading questions, because it helps them in interview strategies used by the Metropolitan Police, Greater Manchester Police and British Transport Police, the process of making sure they write down what’s said in front of them accurately.’ to look for commonalities. Later she called a meeting, Milne and others are now advocating free recall and along with the National Crime Agency National open response, while recognising this is ‘very difficult Vulnerable Lead Kevin Smith, to bring together those for frontline officers. But now we’ve got body worn who had worked in the aftermath of terrorist attacks in order to see what could be learned. Milne and Smith cameras, let’s cut out the middle man… we can just have a conversation on camera.’ eventually wrote the Witness Interview Strategy for Milne has also begun to examine communications Critical Incidents (WISCI). Their paper outlines the importance of developing a strategy for these incidents in fire service control rooms, and the best ways for which takes into account initial contact with witnesses, call handlers to gather information. She will also be looking at body-cam footage from firefighters and the interview and post-interview processes. paramedics to examine their communication on-scene.

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The sibling spotlight Rachel Batchelor on the challenges facing the ‘forgotten’ brothers and sisters of seriously ill children ‘Side by side or miles apart, siblings will always be connected by heart’ – Unknown Siblings can shape our character, share so many experiences with us and may know us better than anyone. Healthy sibling relationships are associated with lower levels of depression and more satisfaction with life. It’s a unique bond, for many of us the longest relationship we’ll have. Our siblings are usually there as we face those defining moments, from our first day of school to the deaths of our parents and finally through our own old age, illness and death. But what happens when those ‘final’ life moments come prematurely?

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ince my undergraduate degree, I have volunteered at Great Ormond Street Hospital. As part of my role at the hospital, I provide therapeutic recreation such as games, crafts and general chit chat to the children and young people on the wards, to help build a sense of normality and create some positive memories during a very difficult time. The patients are sometimes on their own, and sometimes with their families. Beyond the beeping from the machines, the medical surroundings and the seriousness of the situation, it occasionally feels like I’ve entered a family’s living room on a rainy Sunday afternoon. I’m part of their family. In spite of medical advances, substantial emotional challenges come with serious illnesses – carefree childhood innocence can be swept away, replaced by relentless treatments. Patients with chronic and serious illnesses are particularly vulnerable to developing mental health issues. Serious illness can present many additional challenges to the whole family, such as disruption to routines and profound levels of uncertainty. Christine Eiser has noted that a diagnosis of a childhood serious illness places ordinary families in extraordinary circumstances. Being whisked out of the family home into a foreign environment with your child’s care in the hands of strangers, whilst masking most of your own pain, is something no parent should have to experience. As one Dad once told me, ‘If I had the option for the cancer to be in me instead of my little boy, I wouldn’t have to think twice’. Each room I visit at the hospital, I put everything I can into bringing some light to the patients and respite to the parents. However, for some time I failed to acknowledge how difficult the situation must be for the other children who were also being thrust into the confusing world of serious illness – the siblings. One day One particularly memorable day on the oncology ward shifted my perspective. I knocked on the door to a family of five: Mum, Dad and three brothers. The middle brother was the patient and greeted me eagerly with his younger brother, keen to take a peek at the games I had with me. I ended up playing ‘Buckaroo’ with them and after a couple of games, the Dad joyfully joined in too. Meanwhile, the Mum went

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the psychologist november 2019 siblings and illness Getty Images

to grab some lunch and the older brother sat slumped in a chair, complaining to his Dad that the Wi-Fi wouldn’t connect. He seemed irritable. ‘Typical teenager’, I imagined my own parents commenting, and then continued playing. A nurse entered to do a couple of quick checks – a straightforward blood pressure and temperature check, nothing too invasive. I happened to glance back up at the older brother. His previously disgruntled and bored expression had been replaced by one of pain, with a look of sheer love and hurt in his eyes. Pure human emotion which couldn’t be concealed.

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An instinct to protect his little brother from harm, whilst being completely powerless. In the next room I visited, the patient was completely distant, pale and seemingly too ill to engage. His bouncy little sister chatted away to me about how much she loved doing art at school… she needed a red pen to finish her project. Feeling unsure if it was my place to be in the room with the patient being so unwell, I found a nurse on the ward who reassured me that it was really positive for the family to be doing things like this together. She said the boy was unlikely to make it to the end of the week, so it was

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Impacts My interest in siblings led me to study the psychological adjustment of healthy siblings to a paediatric cancer patient, as my dissertation during my final year as an undergraduate. Recent research highlighted that siblings of children with cancer experience a range of emotions, including stress, guilt, hopelessness, embarrassment, anger, loss and anticipatory grief. Further, siblings commonly experience symptoms of distress which fall into the clinical range of psychiatric disorders including

anxiety, depression and PTSD. It has been estimated that approximately 5 per cent of adolescents have met criteria of PTSD at some point (Hamblen & Barnett, 2016) – much lower than the 22 per cent reported in siblings of cancer patients (Kaplan et al., 2013). Interestingly, in a longitudinal study led by Bregje Houtzager, compared to peers, this poor psychological adjustment is elevated from the first few weeks after diagnosis and remains significantly higher at follow-up six months later. Further, siblings of childhood cancer survivors report higher levels of poor psychological adjustment later in life, including increased symptoms of depression and post-traumatic stress, as well as increased hospital contact for mental health disorders compared to individuals without the experience of having a sibling with cancer, highlighting the prolonged impacts on siblings. Collectively, this research suggests that siblings of children with cancer are particularly vulnerable to experiencing emotional difficulties and mental health problems. However, the intensive focus remains on the patient (both clinically and academically) and beyond this on the parents. Are the needs of siblings being overlooked? A recent review by Christian Knecht and colleagues suggested that sibling distress often goes unnoticed by both parents and oncology care teams. That is, in research where measures of sibling psychological adjustment have been completed by a combination of siblings, parents and clinicians,

Faculty for People with Intellectual Disabilities

FPID Annual Conference 2020 28–29 April at BPS Office, 30 Tabernacle St, London EC2A 4UE Our annual conference attracts academics, researchers and practitioners, and features keynote speakers and insightful presentations on recent research. Day 1 – Principles for organisational change that prevent loss of compassion Day 2 – Current issues related to sex and gender and intellectual disabilities Registration now open. Submission deadline: 27 November

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FPID ANNUAL CONFERENCE

important for him to be around his sister. I went back into the room with the all-important red pen, looking back at the sister. It struck me she probably had no idea what was about to happen. Soon, she would leave the hospital for the final time with her grieving parents and would have to grow up as an only child. Only the patient was in the final room I visited that day, but I caught myself glancing up at the photos on her wall – four healthy children laughing together under a glittery banner which read ‘my three brothers’. On my commute home that evening, my thoughts kept going back to the siblings. With their parents often away from home with the patient, ‘normal’ family life probably ceases to exist for these children. It would be no surprise if all of this had a tremendous toll on siblings, yet what support are they receiving?

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the psychologist november 2019 siblings and illness

Further, adolescents have a greater findings have suggested that awareness of their own mortality, sibling reports of psychological thus increasing existential fears, adjustment are not congruent with concerns of the worst-case scenario the reports of others, with poor and a sense of hopelessness. This psychological adjustment often age group is also more likely only being reported by the siblings. to engage in egotistic thinking, Reasons for this might include an resulting in ‘why-me’ reactions understandable focus of parental and feelings of loneliness and attention on the patients, as well as Rachel Batchelor is a isolation. Thus, communicating siblings feeling their issues aren’t postgraduate psychology student age-appropriate information with important enough to burden their at Royal Holloway, University of siblings is fundamental – younger already worried parents. Thus, London. siblings need reassurance it is not siblings may adapt their behaviour Rachel.Batchelor.2015@live. their fault, older siblings might to fit the needs of the family, often rhul.ac.uk need to reframe negative beliefs. internalising their distress. Find @SibSpotlight on Twitter. Involving siblings in the care of the As a result, siblings have been child (i.e. introducing to healthcare labelled as the ‘forgotten child’ team, decorating the patient’s room), and exploring in the context of paediatric cancer. Indeed, whilst feelings through creative activities such as ‘hospital discussing my dissertation topic with people in my roleplay’, ‘worry boxes’ and reading related books personal life (family, friends, colleagues), I was often can be helpful ways of helping siblings to feel both met with responses similar to ‘It’s always the parents connected and informed. I feel for’ and ‘Oh, I’ve never really thought about the Communicating with siblings can also provide siblings’. But don’t siblings matter too? an opportunity to build on healthy coping strategies. Recent research, such as a study led by Rachel Hamama, has reported that higher levels of selfThree factors control and predictive control – in terms of having While we may not be able to remove the main source positive expectations and remaining optimistic – of distress for siblings, we need to consider the factors are predictive of better psychological adjustment in associated with their psychological adjustment. In siblings. Conversely, in a qualitative study conducted reviewing recent literature, three factors in particular by Eli Gardner where siblings were interviewed about have consistently been reported to be associated with their coping strategies and psychological adjustment, the psychological adjustment of siblings of paediatric it was reported that catastrophic thinking and denial cancer patients: knowledge about the cancer, coping may increase the stress experienced by siblings. This strategies and social support. highlights the importance of identifying maladaptive In terms of knowledge, research suggests that coping strategies (e.g. catastrophic thinking) and keeping kids in the dark about their sibling’s cancer facilitating the development of adaptive coping has the potential to do more harm than good. When strategies (e.g. self-control, predictive control) when siblings are shielded from knowing about the cancer, communicating with siblings. they may return this silence and not express their As is the case when dealing with most adverse own distress. Qualitative research, such as a study circumstances, having a strong social support conducted by Juyoun Yu and Kyung-Sook Bang, network has been found to be particularly valuable in has reported that most siblings express a desire to supporting siblings of paediatric cancer patients. As know more about the illness, to help them to feel less families tend to form the central system of support confused and uncertain, as well as more in control of for children and adolescents, parental support is the situation. Beyond the perceived benefits, a recent particularly vital. Thus, it is important for siblings to review of quantitative research written by Incledon still feel as though their emotions are recognised and and colleagues concluded that siblings who have a their voice is valued within the family. Peer support greater understanding reported lower levels of poor has also been found to be associated with sibling psychological adjustment (including symptoms of psychological adjustment. Typically defined as support anxiety and depression). provided by people who have lived experiences, peer Theoretical frameworks from developmental support provides a unique opportunity to facilitate a psychology can be used to help better understand how sense of mutual understanding, through relating to lack of knowledge can result in psychological distress others in a similar situation, thus reducing isolation. across ages. Jean Piaget explained that preschool and This support may be especially important for older young school children view the world as if they are children and adolescents due to the tendency to feel its centre – they believe events are due to them, and alone in their experiences, as well as the tendency to thus experience feelings of guilt or fear that they will be heavily influenced by the thoughts and behaviours be able to ‘catch’ the illness. In contrast, older children of their peers. and adolescents tend to have the ability to think in a Research has reported significant relationships more flexible way and hypothesise potential outcomes.

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between higher overall levels of knowledge about the cancer, adaptive coping strategies and social support, and better psychological adjustment of siblings (Patterson et al., 2011). Guided by these factors, A collaborative approach interventions for promoting psychological adjustment Research which compared pre- and post-intervention in siblings of children with serious illnesses have been measures of distress (e.g. symptoms of anxiety developed. These interventions usually consist of and depression, levels of loneliness) has suggested several sessions in varied formats: individual, group that these are promising methods of promoting and online. Individual interventions involve clinicians working psychological adjustment. We should also note that on a one-to-one basis with siblings. Such interventions having a sibling with a serious illness can result in some positive changes, such as increases in empathy, can be broadly categorised into educational maturity, advocacy and appreciation of what matters. interventions which focus on improving the child’s We need to support siblings, to help facilitate postknowledge of their sibling’s illness and psychological traumatic growth and draw positives from difficult interventions which focus on developing more circumstances. A family-centred collaborative approach adaptive coping strategies. is required, with families, clinicians and academic Alternatively, group interventions look to bolster researchers ensuring a standard of care in future social support. In family interventions, both the practice. Such policies should siblings and parents are typically include routine screening of involved. Parents participate in “Socialising with others in each sibling (including measures activities which parallel the content of the sibling sessions and are similar situations can help psychological adjustment and the associated factors). Impacts on aimed at improving awareness with attitudinal barriers” siblings could be integrated into of the impacts of having an ill training for staff, encouraging open sibling. Importantly, parents and communication with siblings. siblings typically engage in group Schools will also play an important role. Siblings activities and discussions to help develop a mutual of ill children don’t usually have the option of understanding of one another’s distress. When the ‘compassionate leave’ or taking ‘a break’… they are patient is well enough, family interventions (such expected to continue at school and keep up with their as residential camps for families affected by serious classmates. They may well struggle to concentrate, illnesses) can also allow siblings to experience a sense and become withdrawn, putting them at an increased of normality and bond with their family, with the risk of being bullied about their situation. An assigned security of medical support nearby. Peer support interventions, such as group meetings member of staff could build a trusting relationship with the sibling, so they can discuss any concerns. As ever, and residential camps for siblings, there are financial and logistical considerations here. provide a space for siblings to There are, however, things we can all do to make naturally connect with others who Key sources have shared experiences. Socialising a positive difference to siblings. Reach out, open up a space for talk. Show a genuine interest. Make them with others in similar situations Eiser, C. (1997). Effects of chronic illness feel valued, and aware that their identity isn’t defined can help with attitudinal barriers on children and their families. Advances by their sibling’s illness. Look out for any changes – feelings of embarrassment have in Psychiatric Treatment, 3, 204-210. in them, signs of distress. Answer questions directly, been consistently reported as a Incledon, E., Williams, L., Hazell, T. et in honest words which can be understood. Where major stressor amongst siblings. al. (2015). A review of factors associated with mental health in siblings of possible, help to facilitate a routine in the sibling’s life More recently, internet-based children with chronic illness. Journal of – help to create some feelings of normality. Advocate: therapeutic interventions for Child Health Care, 19(2), 181-194. help to make sure the sibling is being acknowledged, siblings have been developed, to Knecht, C., Hellmers, C. & Metzing, S. respected and listened to. And signpost: siblings may help to overcome the barriers of (2015). The perspective of siblings of not know that support is out there for them, so look up accessing face-to-face intervention, children with chronic illness. Journal of what is available in their area and guide them towards such as travel and time constraints. Pediatric Nursing, 30(1), 102–116. Yu, J. & Bang, K.S. (2015). Perceived accessing appropriate support. This might include the Novel delivery methods, such as alienation of, and social support for, Rainbow Trust (support for families with a seriously ill Skype in a study led by Sheryl siblings with cancer. Journal of Pediatric child, https://rainbowtrust.org.uk/), ‘Sibs’ (for siblings Gettings and emails within a study Oncology Nursing, 32(6), 410-416. of disabled children and adults, https://www.sibs.org. led by Margaretha Nolbris, have Zegaczeski, T., Chang, K., Coddington, uk), and ‘Over The Wall’ (who provide life-changing been piloted with positive effects. J. & Berg, A. (2016). Factors related activity camps for families affected by serious health to healthy siblings’ psychosocial adjustment to children with cancer: An challenges, https://www.otw.org.uk). integrative review. Journal of Pediatric Together, we can make a greater effort to protect Oncology Nursing, 33(3), 218-227. and catch these children before they fall. They deserve much more than just a passing thought. It is time for Full list available in online/app version. siblings to have their own spotlight.

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9–10 January at Park Inn by Radisson, Northampton The theme of this year’s event will be ‘A 20:20 vision of educational psychology: play, learning, inclusion and diversity. An exploration of current developments and advancements within educational psychology’. Keynote speakers: • Professor Becky Francis UCL Institute of Education • Professor Rob Webster UCL Institute of Education • Dr Cora Sargeant Educational Psychologist • Thelma Walker MP Commons Education Select Committee • Talk Out Loud Young People’s Mental Health Group • Shooting Stars SEN and Disabilities Group Call for Submissions The DECP welcomes submissions of abstracts, workshops, and posters from full and in-training members. Deadline for submissions 21 October.

www.bps.org.uk/decp2020 #decpconf

DECP ANNUAL CONFERENCE

DECP Annual Conference 2020

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Forging a new politics of work David Frayne, author of The Work Cure, talks to our Associate Editor Emily Hutchinson

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avid Frayne, author of The Refusal of Work (Zed), has written numerous articles for the Independent, New Statesman and the Guardian. He has spent the past year in the Berggruen Fellows program at New York University, exploring how to think about ethics, politics and social relations in a world where work is in crisis. Emily Hutchinson asked him about his new book The Work Cure (PCCS Books), which is out now.

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Can you summarise the key message that you wanted this book to convey? If you follow the charity Action for Happiness on Twitter, you will regularly see advice on how to improve your wellbeing. A recent post suggested that one way to feel happier is to stop disliking your job. The entire political, relational, and ethical problem of work has been reduced down to this single question of individual attitude. I think we are seeing this same trend in a variety of places, whether it’s workplace wellness seminars telling us to meet our troubles with positivity and resilience, or unemployed people being coached to adopt a stronger work ethic. This book says, ‘stop this nonsense’. We have all of these structural problems with work right now: unemployment, precarious work, the ruthless optimisation of efficiency, a proliferation of meaningless jobs, and a lack of respect for people who do not participate in employment. I believe we have to resist the idea that the solution is self-improvement or psychological reform. If each of us is persuaded that we are individually responsible for our work-related troubles, not only does it make us more fit for exploitation,

it also causes us to blame ourselves when things do not improve. The book’s key message is that the problems with work are political, and that the solutions should be too. What prompted you to pull this book together? There are a lot of promising policies on the table for debate right now: the shorter working week, employeefocused flexibility, the Universal Basic Income, ideas for workplace democracy, and initiatives to make life more rewarding for people outside formal employment. I want to see the debate flourish in these areas, but I think there are two major obstacles: one is the tendency to think of work problems as psychological rather than political, and the other is the dogma that employment is the only way to be a healthy and respectable citizen. I wanted to pull together people I have admired for speaking critically about these things. The book includes pieces from academics, practicing psychologists and campaignoriented groups like Psychologists for Social Change and Recovery in the Bin. Who do you want to read it? I want people who are campaigning for a new politics of work to read the book and more clearly see some of the obstacles that stand in the way. I want psychologists to read it and reflect on the ways in which their profession is being co-opted to discipline workers and depoliticise the problems with work. Perhaps workers will read it and think ‘yes, I am not pathological, the sickness is in the system’. Perhaps disabled or mentally distressed people

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the psychologist november 2019 books

will read it and feel more empowered to say ‘no, I cannot work, and that does not make me some kind of deviant’. I would be pleased if that was the outcome. The book contains many challenges to the Department for Work and Pensions (DWP) and organisations such as Action for Happiness. What impact do you hope that the book will have on these organisations? Yes, we call out these two agencies as some of the biggest perpetrators. The work of Lynne Frieldi, Robert Stearn, Roy Bard and others has been very influential here, having focused on the problem of ‘psychocompulsion’ within organisations like the DWP. The DWP continues to impose job coaching on people and promote employment as a health outcome. Recent documents also suggest that our NHS is being enlisted for these purposes. The issue here is much more immediate than a broader depoliticisation of work – the lives of unemployed and disabled people might literally be hanging in the balance because of policies designed to cut benefits, force people into unsuitable jobs, or impose sanctions for non-compliance. The economist Richard Layard also receives some scrutiny in this book, partly for his association with Action for Happiness, but mostly for co-creating the Improving Access to Psychological Therapies (IAPT) program. As many will know, IAPT combines CBT with a focus on work as a health outcome. In the book, Jay Watts and Paul Atkinson argue that this represents a troubling new precedent for the psychology professions, raising all kinds of concerns about consent, ethics and duty of care. Their chapters, as well as my own, also take issue with the accuracy of the core claim that employment improves health. What impact will the book have? I am a realist about these things, so I don’t expect any direct impact, but I do hope the book will encourage people to think in more deliberate ways about how to struggle against these agencies. Books can be helpful for clarifying the nature of a problem, but it is only a collective struggle that can create change. What happens next? One of the points made in the book is that we can ‘raise awareness’ forever, without really changing anything. Fortunately, there are already organisations campaigning in the right direction. Disabled People Against Cuts and Psychologists for Social Change come to mind as two organisations pushing back against psycho-coercion and work-related dogmas. At a broader level, there are also various think-tanks and political groups trying to forge a new politics of work. For me, the most promising are groups like Autonomy, who are moving beyond the demand for more and better jobs with a well-grounded suggestion that we could also be struggling for more free time. I would recommend looking up these groups and seeing what they are doing. Crucially, they are not only thinking about demands but also questions of strategy.

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How to succeed in your degree, with psychology… One piece of advice from each chapter of Paul Penn’s new book The Psychology of Effective Studying (Routledge). Read the evidence behind these tips and an extract from the book on our website at thepsychologist.bps.org.uk/howsucceed-your-degree-psychology • use retrieval practice to help calibrate what you think you know with what you can demonstrate you know • use implementation intentions to help you bring your timemanagement plans to fruition • read and take notes with a view to generating your own understanding of a topic, not simply re-producing someone else’s • in developing your ability to paraphrase, focus on how you are making use of your sources • you sound a lot smarter when you keep your writing simple! [read an exclusive extract on this via our website] • use peer evaluation to make each group member accountable for their contributions • ensure that each of your slides has a purpose that is clearly stated in its title • make your exams easier by making your revision harder

Looking to the future of autism

Autism: A New Introduction to Psychological Theory and Current Debate, by Sue Fletcher-Watson and Francesca Happe, is out now on Routledge. You can read the final chapter, ‘Looking to the future’, on our website at https://thepsychologist.bps.org.uk/ looking-future

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A web of intrigue The Spider’s Thread: Metaphor in Mind, Brain, and Poetry Keith J. Holyoak MIT Press; £28

Perhaps it’s appropriate for a book about metaphor that it doesn’t quite do what it says on the tin. Rather, it is the story of Holyoak’s quest to combine the objective view of the experimental psychologist with the subjective view of the poet – in order to create a kind of one-maninterdisciplinary analysis of metaphor. In the metaphorical blue corner, representing poetry, is Muhammed Ali. In the red corner, for psychology, is Barry McGuigan. Barry’s a fearsome fighter in the right match but he’s woefully underpowered here. In one of the many wonderful poems which herald each chapter, one has the lines: The already known had once more been confirmed By psychological experiment Which says it all really. But the book holds together because, far from this unmasking feeling threatening (as well it might to someone whose primary billing is cognitive psychologist) Holyoak declares it one of his favourites. To push this thought probably too far, might the book actually be the howl of a psychologist desperate to escape the fetters of his discipline? And so to the book itself. ‘The spider’s thread’, Holyoak posits, is language itself; only language offers the filaments to connect our subjective world to a shared one where communication is possible. And what better to oil those filaments than metaphors, whose charms lie in their roominess, their in-betweens? Metaphors are generous, playful; they cast the imagination as queen. I love metaphors but I’m scared of poetry – it’s always felt a bit like gate-crashing a party. So my first appreciation here is of the generosity in both the selection and evaluation of the poems. From Sylvia Plath and Langston Hughes to Allen Ginsberg and Leonard Cohen to

Coleridge and Yeats, there is no shortage of magnificent poetry. Poems are the stars because they can take metaphors and run with them. They extend them, bend them, corrupt them, defy them. The book has plentiful, delightful illustrations of their prowess. Halfway through, Holyoak asks the question we’ve been expecting but dreading: ‘What have psychologists learned about how people understand metaphor and what do their findings tell us about metaphor in poetry?’ Even he concedes that a credible answer is ‘precious little’. The shrinking necessary to render big, deep things testable (decades of research hanging on the line, ‘my lawyer is a shark’) make any return journey hazardous. We dally into evidence of ‘conceptual combination’ - hearing a literal sentence (‘sharks can swim’) prior to a metaphorical one (‘my lawyer is a shark’) interferes with our understanding of the metaphor. We get a peek at analogical reasoning (‘blindness is to sight as poverty is to …’) which activates the left rostrolateral prefrontal cortex. We are treated to the revelation that poets deactivate their control networks when writing poetry (little surprise to anyone who’s had a eureka moment in the shower). My overriding thought through all this was, ‘more poems please’. And back on track, we delve into the special relationship between poet and reader, authenticity, the potential (or lack of it) for AI ever to move us poetically, the unconscious and the strange. Holyoak ends with a heartfelt plea for a new kind of education by poetry, incarnating as it does, a holy trinity of critical thinking, imagination and empathy. If you come to this book hoping to understand how metaphor works in the brain, you’ll likely find yourself wandering in foothills, disillusioned. But if you’re ready for a twisty climb, hand-in-hand with a curious, enthusiastic and steadfast companion, you’ll be rewarded with some wonderful views. This book is a love song to poetry and you’ll surely be singing along. Reviewed by Cathy Rogers, Developmental Neurocognition Lab, Birkbeck, University of London

‘I realised I knew nothing about writing a book…’ On our website find the opening instalments of an evolving reflection on book writing from Emily Hutchinson, Associate Editor of books, as she embarks on a journey to write her first book. Do you have your own book writing experiences to share? Why did you decide to write a book? What did you learn? How did you go about it? Get in touch on psychologist@bps.org.uk or tweet us @psychmag and let us know!

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the psychologist november 2019 books

The secret to great storytelling outcomes of change. Good stories Before picking up this book I also feature flawed characters didn’t know there was a science of with multiple dimensions, who storytelling. It turns out that the undergo some kind of science of storytelling is the transformation until science of the human mind: they and we discover we tell ourselves stories The Science of who they really are. about ourselves and others Storytelling: Great storytellers create to make sense of the world Why Stories these realistic and around us. Drawing on Make Us Human, relatable characters extensive psychology and and How to Tell through a sophisticated neuroscience literature, Them Better understanding of the with scientific advice Will Storr mind. and proofreading from HarperCollins; Rich with outlines Professor Sophie Scott and £12.99 of many of the English Dr Stuart Ritchie, Storr language’s most explains why humans like compelling stories, the book takes us stories, and the kinds of stories we through why, scientifically speaking, like. certain features are so captivating All good stories start with to our story-seeking brains. Part of change, or the promise of change, the fun of this book is all the short says Storr. Our brains are constantly synopses that contain the twists looking for unexpected change; this and turns of great stories, giving allows us to perceive and control the the satisfaction of reading a book or world, making us curious about the

watching a film without having done so – you might have to skip the odd page if you want to avoid spoilers! For anyone keen to write their own story, Storr describes his approach to building characters and plot, developed through his research into the science described throughout the book. An understanding of psychology seems to be an important starting point for writing a great story – as psychologists then, we’re well placed to have go. While much of the research described in the book is familiar, the linking of that research to effective storytelling is novel, and certainly made me think about classic psychological findings in a new way. Reviewed by Annie Brookman-Byrne, Deputy Editor

Two new books landed on our desk which the authors say were partly inspired by writing for us… ‘My intention in writing “Pull up a chair” in The Psychologist in 2017 was to demystify how practicing psychologists might utilise “chairwork”: a somewhat enigmatic collection of experiential interventions which are well-known for their therapeutic power and transformational effects. What I didn’t expect was such a positive response to the article, and from such a variety of different professional psychologists. Buoyed by this positive feedback, and eager to take on a larger writing project, the outlines of a book began to take shape in my mind after writing for The Psychologist. Two years later, Cognitive Behavioural Chairwork has been published by Routledge as a part of its wellrespected “Distinctive Features” series. I am certain that had The Psychologist not shown such confidence in my writing, and had its readers not been interested in the use of “the chairs”, I would have never undertaken this task. Working with The Psychologist gave me the push I needed to fulfil one of my lifetime ambitions and for that I am incredibly grateful.’ Matthew Pugh

‘Illusions are always experienced in context, and writing for The Psychologist significantly helped us think about the contextual parallels in scientific and folk performances of illusions. Rightfully, psychologists want to foreground specific illusions in experimental settings so as to identify and examine the underlying psycho-perceptual mechanisms that govern illusory experience. Our book, Folk Illusions, demonstrates that children and youths — acting a bit like little scientists — also want to foreground specific illusions, but they do so in order to playfully test the boundaries of “reality”. In both cases, we find a robust pattern of human behavior in which an awareness of the illusory tendencies of perception takes center stage. We believe psychologists will be interested in the wide array of body-based perceptual and cognitive illusions documented in the book, many of which have never been studied in the lab at all.’ Claiborne Rice and Brandon Barker

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Find the reason Reviewed by Annie Brookman-Byrne

play Reasons to stay alive Studio Theatre, Sheffield

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easons to stay alive include music, books, and running. But before protagonist Matt (Mike Noble) reaches this conclusion, we witness a near-suicide attempt followed by a long period of all-encompassing depression. Nails the size of knitting needles protrude ominously from the back wall as Matt tries to get through this dark period with the help of his partner Andrea (Janet Etuk). Help also comes in the form of older Matt (Phil Cheadle), who appears in younger Matt’s mind, looking on as the scenes unfold, and encouraging Matt to go on living. Older Matt is also there to assist the audience. He gives information about experiencing depression, explaining what it’s like to have a panic attack, and the little sympathy people offer to a depressed person – Matt’s had more sympathy for living in Hull than for his debilitating depression. Medication doesn’t work for Matt, and he doesn’t seem to seek any other form of therapy. Every day is a challenge, and for a while it seems that the bad times will never end. Matt discovers running. When you run your heart beats fast and you sweat – mimicking the effects of

the panic attacks that Matt suffers. When Matt runs he doesn’t have to worry about why he’s experiencing those symptoms. Matt and Andrea move in with Matt’s parents (Connie Walker and Chris Donnelly) during this difficult time, and things slowly start to turn around for Matt when he manages to get to the shop to buy milk and marmite. When he and Andrea eventually leave the parental home to live alone, it is the stories and journeys found in books that give Matt the ability to survive each day. Books are placed on the ends of some of the large nails on the back wall, demonstrating the slightly less precarious nature of Matt’s situation now. Andrea is amazingly supportive throughout. For the most part, Matt’s parents are supportive too, although at one point his dad suggests that even though you’re not supposed to say this anymore, acting like a man and not crying might be helpful. Later, we are given a list of ‘crap things people say to depressives that they don’t say in other life threatening situations’. The list doesn’t include his dad’s comments, but it certainly could have done.

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the psychologist november 2019 culture

Hope, resilience, and mental toughness

Instead it includes, ‘it could be worse, at least no-one’s died’, ‘try living with someone who has got it’, ‘I get that all the time’, and ‘mind over matter’. The regular breaking of the fourth wall makes this a more educational experience than a typical play. These opportunities are used to emphasise that depression is not a choice and can have horrific consequences. While there are no perfect or healing words to say to someone with depression, Andrea shows that just being there, helping Matt to breathe, and gently encouraging him are at least actions that won’t hurt. Scenes are punctuated by music, lighting, shifting set, and dance and movement from the characters (including final cast member Dilek Rose). These aspects help to convey the changing emotions of Matt and his family. The nails not holding books remain in the background; a reminder that even when things are improving, the threat of depression looms. The play, adapted from Matt Haig’s book and based on his own life, captures the sometimes inexplicable nature of mental illness. Matt has a loving family and there is no obvious cause of his depression and anxiety. Even when Matt becomes a successful author he is overcome with anxiety. Older Matt reassures younger Matt that ‘the storm ends’. While this is true, the storm also returns. Nonetheless, the play shows that living through those storms is worth it for all that life has to offer. On tour until 16 November 2019. We met Matt in our August 2018 issue. Find ‘It’s about editing our lives…’ via thepsychologist.bps.org.uk

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A harrowing incident changed everything for Sabrina Cohen-Hatton. She and her husband were firefighters, working in nearby stations. Sabrina was sent to respond when someone from her husband’s service had been badly burnt: there was a one in four chance it was Sabrina’s husband. She was relieved to find that it wasn’t him, but was then flooded with guilt. The injured man was a friend of theirs. Sabrina found it very difficult to cope, feeling that she had wished the injuries on her friend. Sabrina wanted to make sure that such an incident could never happen to anyone else. She discovered that 80 per cent of injuries across industries occur due to human error. Looking at policies, procedures, and equipment wasn’t going to help her mission, but looking at decision making in stressful high-pressure situations was. That was the start of her psychology journey. An undergraduate degree and a PhD later, Sabrina started work on national research to understand what happens when people make these decisions. Other research had been in the lab or in other industries, but Sabrina’s role gave her access to firefighters in reallife scenarios. She found that the majority of decisions under these high-pressure situations were intuitive, and not analytical. For Sabrina, acknowledgement of this fact is not enough. She is building on this increased understanding to protect against what she calls ‘decision traps’. Sabrina describes her work with great passion, and it is clear that she loves her job. Any psychologist will want to find out more about the scientific findings and implications – we are given just a taster. But psychologists will also be fascinated in Sabrina’s personal story, from her dad’s deterioration following a brain tumour, to her mum’s mental health issues, and her own experiences of homelessness and resulting hypervigilance. When Sabrina became a firefighter 18 years ago, she was the first woman in her station. Her colleagues didn’t use her name at the start, just a derogatory term instead. To this day many people still don’t think of women as firefighters, and in the UK just 5 per cent of firefighters are female (interviewer Lauren Laverne noted that in Ecuador more women are firefighters than men). Sabrina spoke about how damaging toxic masculinity can be for male firefighters too: they can feel that they should be protectors and not seek help for mental health problems. Sabrina’s music choices included ‘Girl on fire’ (naturally), and she said later on Twitter she was very pleased to pick Idles. Her book for the island was Ernest Hemingway’s The Old Man and the Sea, a book which she described as a story of hope, resilience, and mental toughness; three traits that certainly seem to describe Sabrina herself.

radio Desert Island Discs with Sabrina Cohen-Hatton

Reviewed by Annie Brookman-Byrne, Deputy Editor

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Reassessing perceptions of ‘inside’ exhibition Another Me Southbank Centre

‘Another Me’ is the 2019 UK exhibition of the Koestler Trust’s work produced by people in detention. Each year a guest curator undertakes the momentous task of reviewing thousands of pieces submitted by people in criminal justice settings (youth and adult prisons, secure units, and on probation). This year’s curator is Soweto Kinch, an award-winning British jazz and hip-hop musician, who has risen to this significant challenge, appraising over 7000 pieces in order to form his vision. Although the art and its form (be it paintings, drawings, sculpture, poetry, film and music) is diverse and multi-layered, the 150 artworks selected by Kinch this year have a collective mission: to invite visitors to reassess their perceptions of people who have spent time ‘inside’. As Soweto reflects in his commentary of the exhibition, ‘the self can transcend the environment that it is in’ and rarely is this more powerful than in the art of the incarcerated. And in creating the exhibition, the curator was clearly drawn to work that would surprise and educate the viewer, and in doing so might suggest layers, or multiple senses of self. Those of us who work or have had experience of residing in or visiting prisons will be acutely aware of this overarching theme of multiple selves, of things not necessarily being what they seem at first glance, and – to paraphase a newly launched campaign from the Forward Trust (www.forwardtrust.org.uk), tackling stigma towards ex-offenders and

people in recovery from addition – of people being more than their past. In walking through the exhibits (identified by title and the establishment from which they were created and sent) I reflect on Soweto’s observation that ‘Some of the more delicate, less arresting works formed me to reflect more deeply’. As curator he says he found in these pieces ‘a sense of humour, acerbic political wit, a sense of awareness, a sense of social commentary and critiquing their own environments in a way that really surprised and entertained me in equal measures’, and I defy anyone not to be humbled, enthused and educated by this collection. One of my proudest legacies of my term as Head of Department at my institution concern the three annual prizes that we (the Department of Law and Criminology) sponsor, and this year all three pieces made it to the exhibition: ‘Green Screen Advertisement’ is a funny, dark short film created and acted by first time entrants to the awards

from HM Prison & Young Offender Institution Grampian in Scotland; ‘Hiding in the Flowers’ is a beautiful, colourful painting by an artist at HMP Edinburgh; and ‘Change of Scene’ is a striking and clever 3D painting by an 18-year-old entrant from HM Prison & Young Offender Institution Parc in Wales. The show is also interactive, in that visitors are encouraged to complete anonymous feedback forms that are relayed to the artists. I am told by Koestler staff that this is a really powerful part of the process and that artists gain a lot from this virtual interaction with their audiences. Reviewed by Rosie Meek CPsychol who is Professor of Criminology & Psychology at Royal Holloway University of London. Twitter: @DrRosieMeek The free exhibition runs until 3 November. Experience a walkthrough of I’m Still Here, the 2018 exhibition, via https://bit.ly/2nOEJ1V

‘Help the normals’ by Dolly Sen, from the Art & Protest exhibition at Bethlem Gallery. ‘For its new exhibition, the Bethlem Gallery turns to mental health activism. How can art communicate messages from those feeling that they uncomfortably fit within pre-existing power structures? Art & Protest: What’s there to be mad about? has been curated by artist and activist Dolly Sen and weaves together multi-media artworks and protest ephemera. With confrontational content and a bold, evocative aesthetic, the works communicate a strong sense of urgency.’ Alina Ivan, King’s College London

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Read more from Alina on the exhibition on our website via https://thepsychologist.bps.org.uk/stop-pushing-people-river

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the psychologist november 2019 culture

A glorious celebration… and a revelation Michael Hutchence was the beguiling lead singer of knocked Hutchence to the floor, injuring his head. Australian rock band INXS and an archetypal rock star of Although Hutchence immediately attended hospital, he the 80s and 90s; celebrated both for multiple international insisted on leaving; and with doctors apparently putting hits and a string of famous girlfriends. Consequently, his aggression and slurred speech down to drunkenness, when he died by suicide in a Sydney hotel room in he was released. He then spent a month in Christiansen’s November 1997 following a seemingly rapid descent into flat bed-bound and vomiting before agreeing to a brain excessive drink and drugs, his premature demise was scan. dismissed as mere rock ‘n’ roll cliché. This, then, is the crux of the film that transforms Now, Hutchence’s long-time friend and collaborator Michael Hutchence’s story from self-indulgent drug Richard Lowenstein sets the record straight with this addled rock star, to victim of a neglected traumatic brain documentary comprising wall to wall archive footage of injury (TBI) – and about which he insisted Christiansen the performer both on stage and in private. tell no one. The accident, and the subsequent Overlaid with present day audio of those diagnosis of anosmia, which manifested as a 90 film who knew him best, the approach highlights per cent loss of his sense of taste, and complete Mystify: Michael loss of sense of smell, was made public at the Hutchence’s provocatively sensual persona: Hutchence whilst others talk about him, you watch him, time; the actual extent of his TBI, however, was Richard re-establishing his obvious appeal. only known to him and Christiansen. Those Lowenstein Charming footage of Hutchence and a around him witnessed his changed personality, (writer and fresh-faced Kylie Minogue ecstatically in love increased aggression and depression – but had director) is particularly moving, as present-day Kylie no idea that a TBI was implicated. reminisces about their relationship; sharing The incident took place before the first the hedonistic highs, agonising lows, and a guidelines for managing severe head injuries poignant honesty about his profound effect on her. were issued by the US Brain Trauma Foundation Inevitably, a dark side is revealed, including a in 1996, but enough was known about TBIs in 1992 to childhood with arguably narcissistic parents. Explanations mean this film arguably raises more questions than it are noticeably incomplete regarding Hutchence’s answers: would Hutchence’s prognosis have differed departure to the US as a child with his mother when had he remained in hospital that fateful night? Did he brother Rhett was left behind. These three years abroad fully understand the connection between his injury are strangely brushed over, but there is an implication and his changed behaviour and what, if any, help did that Hutchence’s all-consuming love affairs, and their he seek? Furthermore, could the subsequent death of pattern of dramatic and upsetting demise, are connected Hutchence’s partner Paula Yates have been prevented to lasting childhood turbulence. had she had a better understanding of his injury and its Yet whilst these familial travails hint at underlying impact on his mental health? Though this is not revealed demons, the key bombshell is saved until towards the in the film, according to Lowenstein, when neurologists end (though it has been heavily discussed in the media and psychologists were shown Hutchence’s unedited since the film’s Australian release). In 1992, whilst out coroner’s report, they had no doubt that his TBI was with then girlfriend Helena Christiansen, a taxi driver implicated in his eventual suicide. Yet Yates never knew this, and it was reported at the time that she refused to believe it was suicide. Instead, her assertion that Hutchence died from an autoerotic activity gone wrong helped cement his death as something sordid rather than tragic. Twenty-two years is a long time to wait before reshaping the legacy of a man who has arguably been dismissed as just another live-fast-die-young rock star, but there’s no disputing the significance of this film’s insight regarding Hutchence’s decline. Arguably, however, there are two films here – a glorious celebration of Hutchence the magnetic rock star, and a revelation regarding his accident and subsequent decline that cries out for further scrutiny. Indeed, the film might have been extended to accommodate more analysis of this. Nonetheless, Mystify is a moving tribute to a man whose TBI induced mental health issues – and their significance to his life story – were tragically unknown until now. Reviewed by Wendy Lloyd who is a film critic, psychology graduate and MSc student at LSE www.wendylloyd.com

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‘You can always find something inside someone to work with’ Ian Florance talked to Yvette Bates about her role as Senior Forensic Psychologist at HMP Dovegate, which is run by Serco on behalf of the Ministry of Justice. Yvette’s description of her role raised issues increasingly debated by psychologists. How can psychologists improve services (and decrease harmful or inappropriate treatment) for those who have been diagnosed as having a psychological condition? Does the time and finance required to travel the standard route to Chartership stop people from starting the journey, and decrease diversity amongst those who make it? How does psychological thinking influence high level policy?

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Might you have an interesting story to tell about your career path, the highs and lows of your current role or the professional challenges you are facing? If you would like to be considered for a ‘Careers’ piece in The Psychologist, get in touch with the editor Dr Jon Sutton (jon.sutton@bps.org.uk). Of course there are many other ways to contribute to The Psychologist, but this is one that many find to be particularly quick, easy and enjoyable.

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‘My experience’, said Yvette, ‘is that you shouldn’t be put off by the amount of time it’s going to take you to become a Forensic Psychologist. Qualifying later in life gave me time to get experience of many different people and situations. These have helped me develop the skills I use in my job now. I had always worked alongside my studies from the time I was at secondary school, and that built confidence to interact with many different sorts of people. We’re trying to offer opportunities for voluntary experiences at the prison to meet this sort of need.’ ‘People are not defined by their behaviour…’ I raised a number of what seem like linked issues in the forensic psychologist role. It must be an emotionally and professionally demanding one. Is there a tension between responsibility for risk reduction and for meeting client needs and, if so, can that be resolved? How does a successful practitioner learn to cope with what must be sometimes unsafe and often challenging environments? Can forensic psychologists treat people non-judgementally whatever they’ve done? ‘I’ve never had a problem with working in these sorts of environments or with being non-judgemental. As early as my secondary school I got very used to seeing and coping with behavioural challenges. I realised from an early age that behaviour is influenced by environment: I could see at school that, say, bullying was not just an issue of someone being “naughty”; there was more going on than that. And I found I could cope with what seemed like unsafe environments.’ The longer Yvette worked, the more she realised ‘you need the best interests at heart for the person in front of you, whatever their background. Being non-judgemental springs from this and is a core approach in forensic work. You try to understand what has happened and how the person can move forward. You can always find something inside someone to

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the psychologist november 2019 careers

work with, and, your work is also informed by your psychological and social knowledge of how behaviours are reinforced by, for instance, cycles of abuse. I’m not naive, though, and support from colleagues and supervision is critical. Some of the people I deal with have done horrific things. Thinking about it, the thing that often affects me most is cruelty to animals. I need a bit more time to process the emotional response when I read or hear about that.’ ‘Some prisoners have a particular problem with psychologists, not least because psychologists’ reports and opinions are influential in informing life-changing decisions. We have to evaluate the risk someone poses and prisoners can see this as a threat. But in the sort of work I do, you do have the opportunity to spend time with an individual. You aim to establish that you want to create a genuinely collaborative process and the more open they are the better. If I offer an opinion or disagree, I give them the evidence which backs up what I say, then invite their response. My experience as a prisoner advocate – helping prisoners have a voice – has informed this approach.’ Yvette tells me what she finds really fascinating about work: ‘You’re always learning. When you talk to a prisoner, he or she is the expert and you have to listen.’ We moved on to how Yvette’s work on autism has influenced policy. ‘People with ASD have specific, sometimes unique talents’ Autism Spectrum Disorder (ASD) may be significantly over-represented in secure services. This needs more research but it’s been suggested that people who suffer from ASD are seven times more likely than those without to have some contact with the criminal justice system (including offenders, victims and witnesses). ‘But’, says Yvette, ‘even if the incidence is the same as the general population, prisons have to support them. When I noticed autistic traits – I’d worked with sufferers from ASD at a medium secure unit before working here – there was no real understanding. The reaction, when I first came into prisons about a decade ago, was “What’s the relevance of that?” The more I looked the more work needed to be done. There was no diagnostic assessment of autism for prisoners. There was a recent case of a person who had been in prison for 37 years who had a diagnosis of schizoid personality disorder. It looked more like autism to me, and so it proved. How had autism been missed? One

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explanation is the low level of understanding of the condition in the criminal justice system.’ In 2012 Yvette looked at what instruments were available. ‘As a clinician I do use assessments like ADOS-2 and diagnostic systems like ICD and DSM. Formal diagnostic categories can be helpful to release treatment and resources and focus discussions, but you have to understand individual needs. We have a key worker system here and the key worker is often the first person to notice particular behaviours. Most people tend to think of prisons as unchanging, regimented places. In fact they change all the time and noticing how people react to changes helps with diagnosis and treatment planning.’ Good practice in the area involves recognising autism, making provision for it and basing this work on principles of equality. Yvette’s work, which was informed by these principles, ultimately received a commendation from The Butler Trust (which promotes excellence in UK prisons). ‘At the time there was no training package available so I offered support and consultancy on ASD throughout the prison. When I took on the role of Lead for Autism at HMP Dovegate I developed and delivered a training package for staff. I also started to research a new screening tool, specifically looking at ASD in prison environments.’ All this work was

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recognised as best practice in the Government 2014 white paper Think Autism: Fulfilling and rewarding lives, the strategy for adults with autism in England: an update. ‘One important aspect of this is that in our work we try to emphasise that people with ASD have specific, sometimes unique talents.’ Yvette says, ‘I felt like a fraud when I received my commendation from the patron of the Butler Trust, Princess Anne at St James Palace. I felt I was just doing my job.’ ‘The more you do the more you learn’ Yvette’s life experiences threaded our interview and one of her consistent points is that having experiences outside formal psychology training is essential to later practice. ‘My first degree was a joint honours in English literature and psychology, which was unusual: people usually twinned psychology with a social science. But I was, and still am, interested in writing. I got really interested in social psychology – issues like the Milgram experiments and social conformity. My Grandmother had Alzheimer’s and that influenced my interest in cognitive topics like memory.’ ‘I was keen to make psychology a career and, on finishing my degree, I got an assistant psychology post at a medium secure unit. This was hugely educational. I learnt about formal training options which I hadn’t

understood till then, but also experienced working with people who had challenging behaviours, ASD and learning difficulties. For a variety of reasons the next period took longer than I expected. I did a Master’s at the OU to strengthen applications for clinical trainee positions. Then I was told I needed more varied experience. I was a homeowner by then and needed some security and work-life balance. I started looking for forensic psychology positions and got one here at Dovegate. Here I did another Master’s, this time in forensic psychology. I’d originally set myself the goal to attain Chartership by the age of 25. In fact I was 35 when I got there but, as I say, that may be no bad thing.’ Yvette is Acting Head of Psychology at Dovegate, a prison built in 2001, one of the six prisons Serco runs. ‘Staff from private and publicly run prisons keep in touch. The Head of Service left so I’m Acting Head but I can’t commit to that in the longer term. I want to get the Autism Accreditation Pilot process we’re involved in off the ground and completed if possible. I have been asked to write a chapter in a book and that’s renewed my interest in writing and I need more time with my family. In fact I work quite flexibly, but I’d like to improve my work-life balance even more. I live an outdoorsy life and one of my aims is to do the three peaks challenge before I’m 40. So, I’m not slowing down.’

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the psychologist november 2019 interview

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Karla Novak

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the psychologist november 2019 looking back

Needle girls and motiveless malingerers Sarah Chaney on gender, self-harm and attention-seeking behaviour

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and Pyle’s selection of cases was biased… they didn’t n 1906, 35-year-old Daniel P. was admitted to publish all of the needle cases, and the authors they the Royal London Hospital after having, as he explained it, ‘got some needles into himself’… cited wrote only about a small selection of their patients. Of seven ‘needle girls’ articles in the book, Invalided home from the Boer War in 1901 the one referring to a man, 77-year-old Charles Nutter, and with a history of fits, Daniel P. struggled did not specify his sex (Suicide with a darning needle, to make ends meet. His prescriptions were 1887), leaving the reader to wrongly assume that the stamped ‘no means’ on every visit to the patient was a woman. Hospital and by 1909, he was recorded to Selection and emphasis of this kind has suggested be homeless. A radiograph revealed two needles in that women are more prone to self-injury than men the patient’s thigh, although an operation failed to on more than one occasion. In the late 1960s, small locate and remove them. Having initially claimed the studies of inpatients in psychoanalytic hospitals in the needles had only entered his hand and leg, when he north-eastern United States claimed that the typical returned to the Hospital in 1909, Daniel said that he ‘wrist-slasher’ (as some psychiatrists called them) was had ‘got some into back, got some into legs, got some a young, college-educated, white woman. This was just into left arm’. Since his first visit to the Royal London, the type of person over-represented in these private the patient had had needles removed at Birmingham, hospitals, where up to two-thirds Guy’s, Fleetwood and Pipton of patients were female, usually Hospitals. “Of seven ‘needle girls’ from white, middle-class families Had Daniel been a woman, his (Brickman, 2004; Millard, 2013). doctors might have given a name articles in the book, Gould and Pyle referred to his medical history. In 1897, the one referring to to ‘girls’ rather than ‘ladies’ or two American physicians – George a man, 77-year-old ‘women’: a medical shorthand Gould and Walter Pyle – coined for hysteria at the time, implying the phrase ‘needle girls’ to refer to Charles Nutter, did not young, unmarried women. Some a ‘peculiar type of self-mutilation... specify his sex” men were also diagnosed with sometimes seen in hysteric persons’ hysteria around the turn of the of ‘piercing their flesh with 20th century (or hypochondriasis, numerous needles or pins’ (Gould which for many years was considered the ‘male’ version & Pyle, 1897, p.735). In their book, Anomalies and of hysteria) (Micale, 2008). Yet between 1893 and Curiosities of Medicine, Gould and Pyle retrospectively 1910 at the Royal London Hospital, men were far more applied this phrase to a collection of cases published likely than women to receive a diagnosis of ‘mental over the previous 50 years. Both medical and popular disease’ or ‘nil/malingering’, while women were more versions of the book were produced, and the phrase likely to be deemed suffering from ‘nervous diseases’ ‘needle girls’ was presumably intended to play on (hysteria and hypochondriasis). Where self-injury was popular interest in ‘fasting girls’ (on whom they concerned, men and women might be treated quite also included a section). The phrase also, of course, differently, depending on their presumed motive. suggests that all cases were female. For men, concern over malingering (feigned or exaggerated illness) increased rapidly over the last few decades of the 19th century. In three key Hysteria and hypochondriasis medical journals (Journal of Mental Science, British It is possible that Daniel was an exception. After Medical Journal and The Lancet), the number of all, women in the Victorian and Edwardian period articles containing the term soared from less than 30 came into contact with needles and pins more often in 1851 to nearly 300 in the first decade of the 20th than men, and men may have injured themselves century. Similar increases occurred in textbooks and in different ways. But it is also possible that Gould

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Science Museum, London

newspapers. Several historians have linked the concern of malingering to the rise of health insurance systems across Europe: the introduction of accident insurance in Germany in 1871 and the Employer’s Liability Act of 1880 and subsequent Workmen’s Compensation Acts in England raised the possibility of insurance fraud (Eghigian, 2000, 2001; Schaffner, 2001).

Class issues In 1908, Georges Dieulafoy, professor of pathology at the Hôtel-Dieu de Paris, presented a lengthy report of an unusual case. Dieulafoy’s patient was a ‘boy’ of 30, who had suffered from a gangrenous affection of the skin for two and a half years. The young man had consulted numerous doctors and surgeons before ending up It is uncertain how this apparatus was used. It was made by a Mr at the Hôtel-Dieu. On one occasion, the Bouchart in France and consists of a black box with an eyepiece and patient agreed to have most of his arm lens at one end. It is described as a ‘test type apparatus’ for detecting amputated, and had contemplated further malingerers and was used during the First World War operations. Despite this drastic treatment, Dieulafoy came to the conclusion that the with her that I advised her mistress to get rid of her man’s injuries were self-inflicted. In order to prove at once, which was done, and the girl returned to the this diagnosis, he had portions of the skin tested for country’. Despite concluding that ‘it seems hardly corrosive substances and, when these tests proved credible that a person of her age could be so cunning, positive, arranged a confrontation with the patient in and would inflict so much pain upon herself to avoid the presence of his employer. The patient’s confession work’, this nonetheless appeared to Thorpe to be the was secured when Dieulafoy assured him that he would not be held responsible for his previous actions, only possible explanation, given the girl’s station in life. The puzzling cases that became the so-called which were the result of a morbid mental state. ‘needle girl’ syndrome, however, tended to be of However, if he persisted in the deception now that it middle-class women. The British Medical Journal had been uncovered he would become a dishonest referred to these as ‘motiveless malingerers’. man – a malingerer. Work and duty were held up as Distinguished from patients where the reason for selfsignificant factors in self-injury in men, hence the inflicted injury was considered obvious – evasion of necessary presence of the patient’s duty or financial gain – these women ‘assume their employer for this ‘cure’. maladies without any ostensible object in sight, and Self-inflicted injuries in Key sources often to the destruction, apparently, of their social working-class women were happiness’. They were ‘almost invariably of the class sometimes interpreted in the Gould, G.M. & Pyle, W.L. (1897). of those known as “hysterical”. In other words, they same way. In 1889, George Anomalies and Curiosities of Medicine. are of the female sex, arrived at the age of puberty and Thorpe, a general practitioner in London; Philadelphia: Rebman unmarried’ (Motiveless Malingerers, 1870, p.15). In Walthamstow, wrote indignantly on Publishing Co. (Ltd.); W.B. Saunders. the absence of any other symptoms, hysteria became the case of a 17-year-old servant he Micale, M.S. (2008). Hysterical men: The the obvious explanation given the patients’ sex, age, had treated. This ‘healthy-looking hidden history of male nervous illness. Cambridge, MA: Harvard University marital status and class. country girl’ visited Thorpe on Press. several occasions with an inflamed Millard, C. (2013). Making the cut: The hand. Thorpe seems to have been production of ‘self-harm’ in post-1945 Hysterical temperament suspicious from the outset, for Anglo-Saxon psychiatry. History of the Towards the close of the 19th century, doctors ‘her mistress informed me that the Human Sciences, 26(2), 126–150. had begun to talk of the ‘hysterical temperament’, girl was not at all fond of work, Motiveless Malingerers. (1870). British Medical Journal, 1(470), 15–16. characterised by negative traits including a desire and that she had a deal of trouble Weber, F.P. (1911). The association of for attention. The assumption that hysterics desired to get her to do it’. When Thorpe hysteria with malingering. The Lancet, attention was used to explain self-inflicted injury: as examined the young woman’s hand 178(4605), 1542–1543. psychiatrist Maurice Craig put it in 1905, ‘hysterical he discovered a needle, which he individuals not uncommonly inflict injuries upon removed, a procedure that recurred Full reference list in online or app themselves, probably from a desire to obtain the several times over the next week. version. sympathy of others’. Some doctors thought that any Eventually Thorpe ‘felt so disgusted

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the psychologist november 2019 looking back

case of self-injury in a young woman was an example of ‘hysterical deception’ in these ‘highly neurotic, sly, and deceitful’ hysterical women (Callender & Baker, 1872; Jessett, 1896). Early 20th century physicians continued to focus on the gendered nature of self-inflicted injury in relation to hysterical temperament. Dermatologist Frederick Parkes Weber wrote that hysteria was a disorder of the ‘tertiary sex characters’; those psychological characteristics thought to be common to men or women. Going full circle, he used an evolutionary understanding of sexual characteristics to explain the existence of self-mutilation in women.

‘In past ages... simulation or deception of various kinds must often have been serviceable to the weaker female in protecting herself from the stronger (and sometimes cruel) male, as well as in enabling her sometimes to get her own way... therefore, at the present time the facility (instinct) for deception is probably greater in the average female than in the average male’ (Weber, 1911, p.1542).

Weber viewed self-inflicted injury as a female behaviour, rooted in the morally dubious context of deception, even when he thought that social and environmental factors enhanced this manipulative tendency. Preconceptions about women therefore contributed to concepts of hysterical deception and motiveless malingering.

Roots of modern assumptions The connections between Dr Sarah Chaney self-injury, class and gender is a Research around the turn of the 20th Fellow at Queen century are not straightforward. Mary Centre for Publications on needle insertion the History of and skin-picking tended to focus the Emotions. on self-injury in young, middleHer monograph, class women, simply because these Psyche on the Skin: A History cases were often considered harder of Self-Harm is published in to explain than self-harm in other paperback by Reaktion. individuals. It seemed obvious to doctors and surgeons that men s.chaney@alumni.ucl.ac.uk or working-class women who harmed themselves were attempting insurance fraud or avoiding work or duty. Where those explanations were unavailable, self-inflicted injury became medicalised as part of a hysteria diagnosis. Hysterics were also thought to be deceitful and troublesome, craving the attention of others, and these traits began to be associated with self-injurious behaviour. Young women who injured themselves were assumed to prove the duplicitous nature of women in general. Both of these assumptions – that self-harm is predominantly a female behaviour and that it is a negative form of attention-seeking – remained widespread long after the associated views on class and gender shifted.

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04/10/2019 16:52


Two new episodes of the PsychCrunch podcast, sponsored by Routledge Psychology, available now – on running, and creativity

Shortlisted for the 2019 Science Blog Award by the ABSW Science Writers’ Awards for Britain and Ireland

Research Digest www.bps.org.uk/digest ‘Easy to access and free, and a mine of useful information for my work: what more could I want? I only wish I’d found this years ago!’ Dr Jennifer Wild, Consultant Clinical Psychologist & Senior Lecturer, Institute of Psychiatry ‘The selection of papers suits my eclectic mind perfectly, and the quality and clarity of the synopses is uniformly excellent.’ Professor Guy Claxton, University of Bristol 70

psy 1119 p70_71 ads.indd 70

04/10/2019 15:17


Society Trustees www.bps.org.uk/about-us/ who-we-are President David Murphy The British Psychological Society was founded in 1901, and incorporated by Royal Charter in 1965. Its object is ‘to promote the advancement and diffusion of a knowledge of psychology pure and applied and especially to promote the efficiency and usefulness of Members of the Society by setting up a high standard of professional education and knowledge’.

President Elect Dr Hazel McLaughlin Vice President Vacant Honorary General Secretary Dr Carole Allan Honorary Treasurer Dr Roxane Gervais Chair, Education and Training Board Dr Juliet Foster Chair, Practice Board Alison Clarke Chair, Public Policy Board Vacant Chair, Research Board Professor Daryl O’Connor Co-opted Trustees Dr Chris Lynch Professor Clifford Stott Dr Ester Cohen-Tovee Christina Buxton Dr Adam Jowett

society notices DECP Annual Conference Northampton 9-10 Jan 2020 See p.28 BPS conferences and events See p.32 FPID Annual Conference London 28-29 Apr 2020 See p.36 CPD workshops 2019 See p.48 Undergraduate Research Assistant Scheme nominations close 6 Mar 2020 See p.61 Practice Board Awards nominations close 2 Dec 2019 See p.71

Chief Executive Sarb Bajwa Change Programme Director Diane Ashby Director of Communications and Engagement Rachel Dufton Director of IT Mike Laffan Director of Finance and Resources Harnish Hadani Director of Policy Kathryn Scott Director of Membership and Professional Development Karen Beamish Head of Legal and Governance Christine Attfield

Find out more online at www.bps.org.uk psy 1119 p72 motm.indd 73

The Society has offices in Belfast, Cardiff, Glasgow and London, as well as the main office in Leicester (St Andrews House, 48 Princess Road East, Leicester, LE1 7DR).

04/10/2019 15:15


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